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Botox for Migraine Sufferers

October 24, 2009 - 12:03pm 657 reads 2 comments

If you’re one of the 28+ million Americans who suffer from migraine headaches, no doubt you’ve tried every trick in the book to end them quickly and prevent their return. If the standard changes in lifestyle and medications currently available just don’t work well enough for you, here are some resources that may give you new hope.

One option that has been available for several years is treatment with BOTOX® Cosmetic. As reported by otolaryngologist Dr. William Binder more than 15 years ago, the same overworked forehead muscles that cause dynamic wrinkles also contribute to migraines. Relaxing the muscles with BOTOX injections smoothes the forehead and, for many, relieves migraines for several months. When headaches return, most patients find they return gradually, signaling that another treatment may be in order.

In 2002, a Cleveland board-certified plastic surgeon, Dr. Bahman Guyuron, and neurological colleagues teamed up to take treatment one step further. They used BOTOX injections to identify patients who could be helped by targeting forehead muscles for deactivation. Patients were treated with BOTOX as a screening procedure, and 22 of 29 who experienced relief were then chosen for surgery to remove corrugator supercilii muscles—the same ones that cause vertical forehead wrinkles. 21 of the 22 patients reported improvement; almost half of those reporting complete elimination of their migraines.

At the annual American Society of Plastic Surgeons (ASPS) conference in Seattle taking place this week, a paper will be presented that gives even more evidence that the one-two punch of BOTOX injections and surgery can help many migraine sufferers. The paper highlights a five-year study of 100 patients who were first treated with BOTOX. 89 of the men and women reported improvement in their symptoms for at least four weeks; those patients then went under the knife to have the offending forehead muscles deactivated. The ASPS surgeons reported that 22 of the group found their migraines eliminated entirely, 49 patients noted a significant decrease and only 8 experienced no change.

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Diane Porter

I have a best friend who has suffered with severe migraines for years. She participated in a clinical trial for Botox injections and has gotten some relief. Her trial is over now but the results were promising enough that her insurance company has now agreed to pay for her Botox treatments once every three months for two years to see if the relief continues. That started about six months ago; so far, she is at the same level of relief but the migraines have not gone away entirely; in fact, this weekend she had one that took at least two doses of her migraine medicine. A good month for her is when she has had only two or three migraines all month. She is continuing the Botox treatments with the hope that they will continue to help, but also isn't super-excited about having to get 31 (31!) small injections each time (in the forehead and back of the neck). Migraine treatment continues to be a rough road, with different things working for different people. Thanks so much for this post; I hope we hear from some other women who have some experience with this.

Cathy Enns

Thanks for your comment, Diane. From the bit of research I've done, it sounds to me that the surgery I mentioned is promising. I believe it's a fairly minor outpatient procedure, and it seems clear that those who get at least some relief from Botox injections also get relief through the surgical procedure. If your friend hasn't heard about the procedure, you might suggest she visit www.plasticsurgery.org and search on "migraine." I bet more news will be forthcoming in the months and years ahead.

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