Botox Injections Advance Migraine Treatment

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June 25, 2014


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Is that bad headache actually a migraine? Migraines can amount to a debilitating collection of neurological symptoms, with a primarily persistent throbbing on one side of the head.

“The most important thing for you to do if you have recurring migraine headaches is to see a doctor to make sure there are no physical abnormalities in the brain,” said Allan Herskowitz, M.D., a neurologist with Baptist Health Neuroscience Center. “The doctor will run tests and take down a full history of headaches before arriving at a diagnosis of migraines. Then we start with medications.”

If migraine patients don’t respond to medications, or side effects are present, a relatively new course of treatment is proving effective:  Botox injections.

Here are a few facts about migraines and treatment options, including Botox:

How common are migraines?

For chronic sufferers, a migraine can lessen their quality of life, with attacks usually lasting between four and 72 hours. And these attacks can occur  at least 15 days out of the month.

An estimated 18 percent of women and 6 percent of men suffer from migraines in the U.S. About 14 million people in the U.S. experience chronic daily headaches, according to the Migraine Research Foundation.

What are the symptoms?

Migraine attacks are often accompanied by one or more of the following: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. In October 2010, the U.S. Food and Drug Administration approved Botox, the anti-wrinkle shot from Allergan, as a treatment to prevent chronic migraines. The agency’s decision endorses doctors’ use of Botox to treat chronic migraines sufferers, defined as those who have occurrences for at least 15 days a month that are resistant to other medications.

How did Botox become a treatment for migraines?

In the late 1990s, Botox gained fame as a treatment for reducing facial wrinkles. It was later approved by the FDA for cosmetic purposes — to reduce lines between the eyebrows. Botox is also approved by the FDA to treat uncontrolled blinking, crossed eyes, certain neck muscle spasms, strokes and excessive sweating.

Dr. Herskowitz is a Miami physician who was an investigator in the Allergen Botox trials for migraine sufferers. If patients are unresponsive to other medications, he  recommends Botox injection treatments.

“It’s a very effective option for patients who qualify as chronic sufferers, but only after we determine no other cause for their headaches,” Dr.  Herskowitz said.

How does Botox relieve migraines?

Botox works by blocking nerve signals to the brain and relaxing muscles. .

“Botox blocks accessibility of nerve endings and relaxes the muscles,” Dr. Herskowitz said. “Injections are made in specified trigger points around the cranium and neck.”

So far, the results are impressive, he said. There has been no severe reaction to the shots and the side effects are less than with medications.

A Botox treatment for migraines generally involves a total of 31 injections in seven areas — including the forehead, temples, the back of the head, the neck and shoulders, Dr. Herskowitz said. Injections are given about every three months.

“It’s important that you see a properly qualified (Botox) injector,” Dr. Herskowitz said. “Go to a neurologist who has been certified to do this. Botox has the potential of becoming the predominant treatment for chronic migraine sufferers.”

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