03/30/2010 - Articles

Botox may help with migraine

By: Susan Aldridge, medical journalist, PhD


Migraine is a common condition which produces pain that is more debilitating than that of the ordinary tension headache. Dermatologists have noted that people attending to have botulinum toxin (botox) injections to treat wrinkles sometimes reported relief from migraine. But follow up research failed to show that botox was any better than placebo for migraine.

It may be that only certain types of migraine will respond to botox, according to a new study from dermatologist Dr Christine Kim, who works in California. She and her team studied 18 patients of average age 51 who had already received or were planning to receive botox injections for cosmetic reasons. All of them reported having migraines.

Kim divided the patients into two groups according to the type of migraine pain they experienced. Patients with imploding migraine had pain that was crushing and vice-like, while those with exploding migraine had a feeling of great pressure building in their heads, as if it could split or even explode.

Three months after their botox treatment, 13 patients had a reduction in migraine pain. Ten of them have imploding migraine and three of them had exploding migraine. The six non-responders all had exploding migraine. Overall, there was a reduction in migraine days from 6.8 per month to 0.7 per month. In exploding migraine, the reduction was 11.4 to 9.4 days per month and in imploding migraine, it was 7.1 days to 0.6 days per month.

So botox is more likely to work in imploding migraine. It is not, as yet, clear how it works. Botox smoothes wrinkles away by producing muscle paralysis but a different mechanism is more likely in reduction of migraine pain. The findings suggest that a larger clinical trial of botox in imploding migraine would be in order now.



Kim et al Predicting migraine responsiveness to botulinum toxin type A injections Archives of Dermatology February 2010; 146:159-163


Created on: 03/30/2010
Reviewed on: 03/30/2010

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