Widely known as a wrinkle treatment drug, Botox has also been proven to be effective in treating different medical conditions including migraines. It has been approved by FDA in 2010 as an effective treatment for treating chronic migraines and headaches in adult population.
What are migraine symptoms?
Migraines are highly painful & debilitating headaches causing severe pulsing or throbbing pain significantly effecting quality of life. Chronic migraine headaches are experienced by the patient for more than 14 days of the month.
Migraine usually occurs in one side of the head, settling behind one eye while occurring sporadically or frequently. The attacks of the headache may last for 4 to 24 hours with the similar symptoms as mentioned above. There are numerous causes for these types of headaches including fatigue, tension and stress, exposure to bright sunlight, changes in sleep patterns or diet, hormonal changes, oral contraceptives, strong odours, nitrates in certain foods or alcohol.
What are cluster headache symptoms?
Cluster headaches cause intense pain in one side of the head in cyclical or cluster patterns. It causes frequent painful attacks which may last for weeks or months.
These headaches cause intense throbbing or constant pain and may cause burning sensation. The location of pain is just on back of one eye or in the area of eye and it does not change its position. The patient can experience pain manifestations several times in a day or it can vanish for months and can return due to exposure to any of the triggers. The triggers of the cluster headaches are similar to that of aura migraines.
These types of headaches are different than the normal kind. They are much more severe accompanied by symptoms like searing pain occurring on one or both sides of the head, causing visual distractions and nausea, vomiting, breath shortness, excessive sweating along with increased light, smell or sound sensitivity. Migraines and cluster headaches cause significant impairment in routine life and interfere with family, working and social life.
Pain & Migraine medicines do not prove effective for all patients in relieving pain and in some instances doctors may prescribe preventive medications. These medicines help in reducing the frequency and intensity of headaches. According to one of the study published in the journal of Neurology, almost one third of patient population suffering from chronic migraine headaches take preventive medications.
Other types of migraines
In UK, about 25% of the women 1 in 12 men experience migraines at some point of their lives. The cluster headaches on the other hand are rare, affecting about 1 in 1000 individuals. It is noticeable that Botox does not treat all type of migraines and headaches as these are of different types.
Other less common types of migraines include migraines caused by menstrual cycle, displaying similar symptoms as migraines with aura, abdominal migraines which are occur more frequently in children, ocular migraines causing temporary vision loss and hemiplegic migraines that are quite rare and cause the symptoms as previously mentioned, along with weakening one side of the body.
How Botox treats migraines and cluster headaches?
Botox has been officially approved by FDA in July 2010, for the treatment of chronic migraines. Though Botox is known to induce paralysis of muscle by blocking the release of acetylcholine neurotransmitters from nerve endings which results in reduction of wrinkles and resolve muscle spasticity. Along with this, it helps in reducing the release of pain related neuropeptides and also blocks the feedback loop transmission of pain sensation that is why it is also used for reducing lower back pain, treating the pain in bladder, neuropathic pain and myofascial muscle pain.
Although not all headaches types does not respond well to Botox but headaches which are referred to as imploding ( squeezing, throbbing, cyclic etc.) have a higher rate of response to the Botox injections (>80%) as compared to the headaches referred to as exploding (15%) (Source: Exploding vs imploding headache in migraine prophylaxis with botulinum toxin A. Pain. 2006;125(3):286-295).
Numerous clinical studies has been conducted to prove the effectiveness of Botox in treating headaches and migraines but the results of the studies showed that Botox treatment prove effective in treating only the migraine and cluster headaches and not a good cure for any other form of headaches. According to the results of one of the clinical study, 70% of patients suffering from chronic migraines experienced 50% reduction in their migraine headache days
(source: Allergan Inc,November 14, 2011, CNW – Health Canada approves BOTOX® as prophylactic treatment for chronic migraine).
Typically, Botox for migraine treatments is administered once after every three months period. The complete Botox for migraine treatment span is 12-15 months. The treatment is performed in an outpatient clinic by an expert and experienced doctor. The multiple yet small doses of botox are injected, at the certain point along the nose bridge, the temples, the back side of the head, on the temples, neck, forehead and on the upper part of back.
The Botox for migraine injections does not give a relief from headaches or migraines right away. The improvement can take up to 10-14 days. In some cases, the patients may not experience relief from symptoms after receiving their first treatment. Successive treatments prove to be more effective.
Researches have proved that patients experience 50% reduction in the frequency of headaches after receiving 12 months of Botox for migraines treatment.