Using Botox to Prevent Chronic Migraines

A Well-Tolerated, FDA Approved Technique to Prevent Chronic Migraine

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Will Botox Prevent My Migraines?. Ted Smith/Caiaimage/Getty Images

Botox is most known for its use in reducing facial wrinkles, but it's also used as a preventive treatment for chronic migraines.

What is Botox?

Botox a purified and diluted form of botulinum toxin A, a toxin produced by a bacteria, which is responsible for botulism. Botulism is a deadly food poisoning most known for its paralyzing effects on the muscles, including the muscles responsible for breathing.

How Does Botox Prevent Migraines?

Researchers noticed that many migraine sufferers who had Botox injections for wrinkles reported having fewer migraines. It's unknown exactly how the Botox reduces migraine frequency, but it only seems to be effective in those with chronic migraines, not with those who suffer from episodic migraines or chronic tension-type headaches. Although, future studies on using Botox for chronic tension headaches may prove otherwise.

bridge of the nose, the forehead, the temples, the back of the head, the neck, and the upper back (just above the shoulder blades).

Botox is injected over a ten to fifteen minute period into the muscles around the bridge of the nose, temples, forehead, back of the head near the neck, and upper back. The procedure may burn a bit, but the discomfort is short-lived and generally well-tolerated.

Botox is used as a preventative medicine, requiring treatments every 12 weeks to work most effectively.

Some people do not experience relief with Botox after the first session, but do have 

Is Botox FDA Approved?:

Botox was approved to treat chronic migraines in October 2010. Prior to that, it was used off-label for this purpose. Botox is also approved for use in certain disorders of the eyes, torticollis, and facial wrinkles.

In addition, it's used to treat severe forms of overactive bladder and underarm sweating.

What Types of Side Effects Might I Experience with Botox?:

In rare cases, symptoms similar to botulism have been reported after using Botox. The exact rate of these reactions is not known. The most common adverse effects associated with chronic migrainuers receiving Botox included neck pain and headache (go figure—this is still relatively rare though, only a few people out of a hundred).

Other potential adverse effects include:

  • loss of strength, general muscle weakness, or muscle tightness
  • eyelid drooping
  • coughing or breathing difficulties
  • injection site pain
  • rise in blood pressure

Even more rare adverse effects may include:

  • dizziness
  • dry eye
  • eyelid swelling
  • difficulty swallowing
  • eye infection
  • jaw pain

Is Botox Safe to Use While Pregnant?:

Botox is a Pregnancy Category C medication, meaning there is not enough research to determine if it is safe to use while pregnant. Your obstetrician will need to help you determine if the risk of using Botox is greater than the potential benefit of treatment.

The Bottom Line

Botox injection is a safe, relatively simple technique that can be used to prevent chronic migraines. The good news too is that it's not an all or nothing approach. Rather, its often used as a complementary treatment, meaning you can probably still take your abortive migraine medications as needed, and potentially even your migraine preventive medication—the double whammy approach could be your best bet.

Sources:

 Allergan Pharmaceuticals. (2016). Botox:Highlights of Prescribing Information. 

Evers, S., Rahmann, A., Vollmer-Haase, J., & Husstedt, I.W. (2002). Treatment of headache with botulinum toxin A-a review according to evidence-based medicine criteria. Cephalalgia;22:699-710.

Jackson, J.L., Kuriyama, A., Hayashino, Y. (2012). Botulinum Toxin A for Prophylactic Treatment of Migraine and Tension Headaches in AdultsA Meta-analysis. JAMA; 307(16):1736-1745.

Modi, S., & Lowder, D.M.(2006).  Medications for migraine prophylaxis. American Family Physician, Jan 1;73(1):72-8. 

Rothrock, J.S. (2012). American Headache Society. Headache Toolbox: Botox-A for suppression of chronic migraine: commonly asked questions

Silberstein, S., Matthew, N., Saper, J., & Jenkins, S. (2000). Botulinum toxin type A as a migraine preventive treatment. Headache;40:445-50.

Edited by Dr. Colleen Doherty May 15th 2016.

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