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The treatment is used as a preventative treatment in chronic migraine. There is some evidence of it’s use in hemicrania continua, trigeminal neuralgia and other facial pains. Preventative drugs DO NOT cure migraines and will not leave you completely headache free but should reduce attack frequency by at least 30%. Botox is injected around the head and neck muscles. It is thought that the treatment blocks pain signals that indirectly block the development of migraine.
Before Treatment
Before recommending treatment, your doctor will have checked that it is a suitable treatment for you and will discuss with you what the treatment involves and what you can expect. You may be asked to continue with your migraine diary. Your doctor will inject tiny amounts of botulinum toxin type A into the muscles around your head, neck, and shoulders. Each session will need 31-39 injections and will take about 15 minutes. The injections are repeated every 12 weeks until the patient is no longer experiencing chronic migraine or if the treatment doesn’t work. It can take several days to a few weeks for Botox to work and most individuals wont see a response until after the second course of injections. Botox is effective in 65-70% of people. With around 50% of those patients experiencing a 50% or more improvement in their headaches. Only 10% of individuals will respond after the 3rd course if the first 2 were ineffective.
Further Information
Those who are trying for a family, pregnant or breastfeeding may not have Botox. The risk of Botox are increased in those with other neurological conditions such as Myasthenia Gravis and in those who had cosmetic botulinum toxin recently (within 3 months). Like all medicines, Botox can cause side effects, although not everybody gets them. In general, side effects occur within the first few days following injection and last only for a short time. In rare cases, they may last for several months or longer. Less than one in 10 will experience a worsening of their migraine (normally lasts a few days); rash, itching; pain, bruising, infection; drooping of eyebrows or eye lids (can last around 6 weeks); muscle weakness, pain; pain in the neck which can begin after a couple of weeks. Less than 1 in 100 may experience problems swallowing, jaw pain or swollen eyelids. The Botox information sheet will have more information.
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