Botox was approved by FDA for the treatment of chronic migraines in early October 2010. In injectable form Botox is called onabotulinumtoxin A.
How Botox works for Migraines?
Botox has capability to block release of certain brain chemicals including acetylcholine. It also blocks movement of certain muscles and nerves. Though it’s still how Botox exactly reduces stiffness and headache pain, but it works. Maybe, it blocks nerves that send out pain messages to the brain and also relaxes muscles so they are much less sensitive to pain.
Patients have reported differing levels of success with each type of migraine treatment. Some may get relief much earlier than others, while in others symptoms may completely go away. Earlier Botox was evaluable in two well designed studies that including patients that were not taking any kind of migraine prevention medication but were experiencing more than 10 days of probable migraine headache each month lasting 5 hours daily. Results included meaningful and measurable differences after 25 weeks as compared to people who received sugar injections including:
• Total number of headache days/ 28 days: Patients who received Botox reported 2.7 fewer headache days as compared to the placebo group (8.1 to 9.6 fewer days for the Botox group, versus 7.2 to 7.5 days for the placebo group, respectively)
• All those who received Botox also experienced reduction in total number of headache hours as compared to the placebo group.
Forms of Botox available for Migraine Treatment
Patients get Botox in injectable form. Botox Cosmetic (one that is used to treat facial wrinkles) and Botox both have same ingredients but have different labeling and different uses. When administered for chronic migraine, Botox is actually diluted and patient receives series of 31 injections across 7 specific regions on both sides of neck and head. This treatment is to be repeated every 12 weeks.
Approximate Treatment Cost
Typical dose of migraine treatment is 155 units, but a cost of 100 unit Botox vial is currently around $550.
Common Side Effects
Generally, Botox treatment is well tolerated by most of the patients and few may experience minor side effects. Some of these are:
• Facial loss of movement
• Eyelid drooping
• Neck pain
• Lung inflammation
• Muscle stiffness and weakness
• Pain at injection site
• Muscle pain and spasms
• High blood pressure
Serious side effects
In rare cases, the paralyzing effect of Botox can even spread to other body areas and can cause double vision, general weakness, voice and speech disorders, difficulty swallowing, difficulty in breathing and loss of bladder control. The spread of Botox effect beyond the areas treated for approved doses have no generally been reported.
Who should avoid Botox for migraines?
Botox is not meant for every patient. You should avoid Botox if you’re allergic to any of its ingredients, have a skin infection at the site where Botox is to be inject, or have had an allergic reaction to the similar products. Caution should be exercised by all those who have any disease that affects nerves or muscles, those with bleeding or swallowing problems as well as those who experience facial weakness such as recent facial surgery or dropping eyelids. It is not known whether Botox is safe for pregnant or breast feeding women.