Migraine

Botulinum toxin is approved for the treatment of chronic migraine (15 or more headache days a month, each lasting 4 or more hours) based on evidence of efficacy from the PREEMPT clinical trials. In these trials botulinum toxin injections prevented on average 8 to 9 headache days a month and improved quality of life for migraine sufferers.

You will first have a face-to-face consultation with your doctor and go through a medical history and migraine questionnaire to assess your suitability for the treatment.

If you are suitable your forehead, temporalis, trapezius, neck and scalp is mapped and the approved dose of botulinum toxin of 155 Units is administered at 31 injection sites divided across 7 specific head/neck muscle areas.

The injections are administered using a tiny needle and are not painful. Onset of migraine relief will take usually 2 weeks and the effects will last for 3 months.

We offer a ‘mini’ migraine/tension headache/eye strain botulinum toxin treatment for 270 which is the usual 3 areas treatment (frown, forehead & crow’s feet) – this mini treatment doesn’t treat the trapezius, temporalis and occipitalis muscles and uses 50 units of botulinum toxin rather than 155 units. The mini treatment whilst not the full migraine botulinum toxin protocol does lessen frequency and severity of headaches for many people.

Although proven in phase 3 clinical trials and in several real world studies to have significant efficacy for decreasing frequency and severity of migraine attacks, it is not fully understood how botulinum toxin achieves this effect

Postulations are as follows:

Botulinum toxin decreases underlying tension and tone of the musculature of the face, scalp and neck and it is thought from studies that it also acts on other pain stimulatory pathways such as the following:

• BTX-A may block calcium-mediated release of substance P
• Lab studies suggest that botulinum toxin type-A may also inhibit other pain neurotransmitters.
• It reduces capsaicin-evoked pain and neurogenic vasodilation.