Why is botox used for migraines
Botox is a medication that uses a form of botulinum toxin to paralyze muscle activity temporarily. Best known for its ability to reduce the appearance of facial wrinkles, Botox also has been shown to help prevent chronic migraine headaches in some people.
Since , doctors at Mayo Clinic have treated thousands of patients with chronic migraine effectively and safely using Botox. The medication typically is injected into muscles of the forehead, scalp, neck and shoulders. The specific details of how Botox works to prevent headaches are not known. The medication then deactivates those pain receptors and blocks pain signals that the nerves send to the brain.
After several months, the nerves sprout new pain fibers, and the headaches tend to return. The Botox effect usually lasts about two-and-a-half months.
Because injections are repeated no sooner than every three months, some people need other headache treatment for the last two weeks of a Botox cycle. Providing Botox treatment for headaches every three months is a national standard, as recommended by the American Headache Society. The treatments are not given more often due to a small possibility that, if you receive Botox more frequently, your body might build up antibodies to botulinum toxin. Preparing for the holidays? Botox is a brand of botulinum neurotoxin BoNT , a protein substance originally derived from the bacterium Clostridium botulinum.
In its original form it was the toxin responsible for botulism, the paralyzing illness often caused by eating contaminated food.
BoNT is now used to treat a number of medical conditions including muscle spasms, excessive sweating, overactive bladder, and some eye muscle conditions. However, one of its most common uses is in the preventive treatment of chronic migraine.
Nonetheless, since migraine itself is so common, this condition ends up affecting a large number of people and can be extremely debilitating. A recent meta-analysis pooled the results of multiple prior studies to investigate the usefulness of Botox, a brand of BoNT, in reducing the frequency of chronic migraine.
The results suggested that there was benefit from this treatment; it not only improved quality of life and significantly reduced the frequency of chronic migraine headaches, but did so with few and mild side effects.
Botox was introduced for treatment of chronic migraine in , after some people receiving injections for cosmetic treatment of facial lines reported improvement of headaches. Initial studies after that observation produced conflicting results. Then in , two large studies showed enough benefit reduction in headache days and improved quality of life that the FDA approved this treatment for chronic migraine.
Botulinum neurotoxin is taken up into nerves, where it may modify the release of neurotransmitters, chemicals that carry signals between brain cells. This is the original mechanism responsible for the paralysis in BoNT poisoning. However, this same process in other nerves may interrupt pain production by blocking the release of pain-producing chemicals such as substance P and calcitonin gene-related peptide CGRP.
Although not yet proven, this process could lead to a turning-down of pain processes inside the brain that may be responsible for chronic migraine. Although this mechanism can reduce headache frequency and severity, it does not seem to change the underlying migraine condition. Theoretically, the spread of BoNT from the site of injection to other areas could result in muscle weakness or paralysis, and doctors usually avoid using BoNT in people with muscle weakness conditions.
In practice, however, body-wide reactions or side effects are rare. Mild injection-related irritation is sometimes reported. At times, temporary eyelid drooping or a change in facial expression resulting from the loss of forehead lines can be seen.
When given by an experienced and qualified health care specialist, botulinum toxin injections are relatively safe. However, some people experience pain, bruising or swelling where the drug was injected.
Other possible side effects are:. Very rarely, if the toxin accidentally spreads into your body, other, more serious symptoms might occur over the course of hours or days.
Call your doctor right away if you notice :. Health Home Treatments, Tests and Therapies. What You Need to Know The injectables used to treat migraines are the same kind used by aesthetic surgeons and dermatologists to minimize facial wrinkles. How do botulinum toxin injectables help treat migraines? Why might I need botulinum toxin injections for migraine treatment? Migraine Treatment with Injectables — What to Expect Using a very small needle, a specialist injects botulinum toxin into the tiny muscles under your skin throughout various areas around your face, head and neck.
What are the risks of using injectables for migraines? Other possible side effects are: Headache or flulike symptoms Dry or watering eye Drooping on one eyelid, eyebrow or side of the mouth Drooling Very rarely, if the toxin accidentally spreads into your body, other, more serious symptoms might occur over the course of hours or days.