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By admin, July 20, 2010 2:04 pm

If you or someone you know suffers with stubborn migraines that drugs can’t touch, you may find help from, of all things, Botox. Famous for erasing wrinkles, if not only temporarily, this neurotoxin from the bacteria that causes botulism has been shown in a new study to provide dramatic relief for a very specific subgroup of migraine sufferers. Alan M. Rapoport, MD, clinical professor of neurology at the UCLA David Geffen School of Medicine and founder and director-emeritus of the New England Center for Headache in Stamford, Connecticut, stated that for some, Botox provides “amazing” relief.

The discovery of Botox for migraine pain was an incidental accident. Back in the 1990s, a California ENT surgeon observed that a number of patients he injected with Botox to remove wrinkles said that they were experiencing fewer headaches. Though doctors initially interpreted that to mean that Botox could reduce tension-type headaches, it turned out that only migraines responded. It’s believed that Botox helps these patients by preventing release of certain inflammatory chemicals that affect the nerves in the head and neck.

Who Feels Better?

Curiously, Botox does not help patients who have occasional migraines; but it can offer relief for 40% to 50% of chronic sufferers of a particular type: Ocular migraines (described as crushing, imploding or eye-popping), the kind that are felt in the eyes. It effectively relieves the number, intensity and duration of headaches.

The standard treatment with Botox for headache is to inject tiny amounts over the bridge of the nose and above the eyebrows and in the temples in a quick (10 minutes or so) in-office procedure. If you get migraine pain in other areas, injections can be tried in those spots as well. While some patients notice some benefit within a few days, most find it takes up to three weeks to get real relief, says Dr. Rapoport, adding that relief usually lasts for three or four months. These Botox treatments can be given again and again. Dr. Rapoport told me that he has treated one woman this way for eight years with continuing success.

Botox for migraine is an off-label use, although the FDA is currently weighing its approval for chronic migraine. According to Dr. Rapoport, the statistics support its safety, with 95% of patients experiencing no side effects at all. At about $350 to $900 per treatment for the medicine alone (treatment can take one to two vials per visit), relief can be costly. But for chronic sufferers, the cost is perhaps well worth it. For some lucky patients, insurance will even lower the cost.

Source(s):

Alan M. Rapoport, MD, clinical professor of neurology at the UCLA David Geffen School of Medicine, Los Angeles and founder and director-emeritus of the New England Center for Headache, Stamford, Connecticut.

Reprinted with the permission of:
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