To treat people with chronic migraines, the FDA approved Botox (onabotulinumtoxinA), an injection of botulinum toxin A, in 2010. Patients who suffer from 15 or more migraines a month can benefit from using Botox for migraine treatment, but the procedure comes with its own set of risks. This overview discusses the benefits and risks of Botox injections for the treatment of migraines.
What Is Botox Used for?
Botox is a botulinum neurotoxin, or nerve poison, produced by the Clostridium botulinum bacterium. Botulism is caused by the same type of bacteria. Intravenous administration of this neurotoxin, on the other hand, has a more focused effect and is less harmful. Slurred speech, drooping eyelids, and muscle paralysis are all signs of botulism.
Why Do Chronic Migraine Patients Use Botox?
Botox is best known for its ability to reduce the appearance of wrinkles on the face by temporarily blocking nerve impulses. Injections of botulinum toxin are used to treat chronic migraines by blocking the release of chemicals that activate the brain’s pain network at nerve endings associated with pain.
A Botox injection may be necessary if other treatment options, including medication and lifestyle changes, have failed to control chronic migraine. There are seven points on the forehead, temples, side and back and neck where these injections are given.
Botox injections have a temporary effect, so a follow-up treatment is advised every 12 weeks. As a result, you’ll need to see your doctor on a regular basis for the duration of your treatment. If you don’t see results after a few visits, you may have to take prescription medication to get the best results.
When Using Botox for Migraine Treatment Makes Sense
Botox injections aren’t a first-choice treatment for chronic migraine, and they’re only considered if other treatments haven’t worked. Acute migraine, defined as 15 or fewer attacks in a month or less, is not a good candidate for this treatment.
Contraindications (not advice) or additional monitoring and caution may be required for their use, even though they are generally well tolerated. Among them:
- Botox allergy: If you are allergic to the botulinum toxin in Botox, it is possible that you will experience anaphylactic shock, which includes swelling, difficulty breathing, nausea, vomiting, and skin rashes.
- Neuromuscular disorders: Myasthenia gravis and Lambert-Eaton syndrome, both of which affect the junction between nerves and muscles, can lead to respiratory problems.
- Infection at the injection site: The treatment is stopped if an infection occurs as a result of injections.
- Being pregnant or breastfeeding: There hasn’t been enough research done on the safety of Botox during pregnancy or breastfeeding. It is typically not advised for this population.
- Age: This treatment is typically avoided in children under the age of 18 because it hasn’t been proven safe.
- Issues with the respiratory system: A history of respiratory problems may also warrant caution, as Botox has been shown to impair lung function.
Preventive vs Abortion-Inducing Drugs
- Abortives: Abortives are medicines that can be taken during a migraine attack. They can be triptans, NSAIDs, and newer CGRP inhibitors that are only for migraines.
- Preventive: Preventive medications are regularly used to help prevent migraine attacks from occurring. This category has several medications, including the most recent CGRP inhibitors explicitly designed for migraine. Botox and anti-seizure and antidepressant medications are older ones that can be used to help prevent migraine attacks.
- Transcranial/nerve stimulation: In complex cases, some therapies aim to scramble and stop pain messaging by stimulating the cranial nerves. Magnetic waves are delivered through the skin to specific nerve bundles near the head and temples during transcranial magnetic stimulation (TMS). Similarly, electrical stimulation can be provided at home with the help of specialized equipment.
- Treatments based on behavioural therapy: Cognitive behavioural therapy (CBT) and other therapies promoting relaxation and managing chronic pain have been shown to be effective in conjunction with other treatment methods.
- Alternative medicine: There is evidence that regular acupuncture treatment, which involves inserting needles into the skin to stimulate nerves, can help reduce the frequency of migraine attacks. Acupuncture is used in conjunction with other therapies.
Even while receiving Botox injections, you’ll most likely need to continue with other treatments to keep the condition under control. Also important is keeping track of one’s own progress and development.
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