As anyone who has ever suffered through one knows, a migraine is not ‘just a headache.’ A migraine attack can last for several hours or days, and the resulting sensitivity to light, nausea, and pain often severely interfere with daily activities.
According to the Mayo Clinic, a typical migraine can last anywhere from 4 to 72 hours if left untreated. Some medications not only reduce the severity and duration of migraines but may help to prevent them. One of those is Botox®.
Types of Migraines
The International Headache Society defines migraines under two specific subtypes:
- Migraine with aura (visual disturbance such as brief flashes of light, blind spots, squiggles in the middle of the vision field), or other neurosensory sensations such as tingling in the fingers, the face, or the lips. For some, the aura migraine also causes slurred speech, an inability to use the correct word, or an inability to speak clearly. For many, the aura usually occurs 20 minutes to an hour before the actual migraine strikes and is considered a warning sign. The American Migraine Foundation estimates that approximately 25% to 30% of people experiencing migraine headaches also experience the aura.
- Migraine without aura
Medications used for Migraine Headaches
Medications such as triptans used in the treatment of episodic migraines, which can occur infrequently or number less than 14 headaches a month, have proven effective for many. In recent years, other drugs not typically associated with pain relief have been used in the treatment and nominal prevention of migraines.
Among them are these three drug categories:
Typically used in the treatment of high blood pressure or hypertension. Such medications are also known as beta-blockers, calcium channel blockers, and angiotensin receptor blockers. These can help relieve pain from migraines caused by constriction and narrowing of blood vessels, activating pain receptors.
Also known as anti-seizure medications, such drugs may be effective in reducing the severity of migraine attacks caused by erratic chemical signal changes in the brain’s nerve cells, which instruct the blood vessels to constrict and dilate, triggering the migraine.
Because stress or tension is believed to induce different types of headaches, including migraines, the use of antidepressants might also be an effective pathway in blocking the release of some neurotransmitter receptors that contribute to headaches, including migraine episodes.
But what about preventive treatments?
Historically, pharmacological treatment of chronic migraines (15 or more migraines a month) focused on reducing the duration and severity of acute migraine attacks. However, overuse of such medications can trigger increased migraine attacks. As such, prophylactic medications like Botox are often recommended today, depending on each patient’s medical status.
Why Botox® Prevents Migraines
Botox – most often associated with plastic surgery procedures – has gained attention as a beneficial preventive treatment of chronic migraine. Botox is a brand name for botulinum neurotoxin (BoNT). While in its original form, the toxin is responsible for botulism found in contaminated food, its derivatives are used today to treat a number of medical conditions such as muscle spasms and overactive bladder.
According to the American Migraine Foundation, Botox, otherwise known as onabotulinumtoxinA, has been approved as a treatment for people experiencing over 15 chronic migraine headaches every month.
Botox has been used in chronic migraine treatments since 2000 but was approved by the U.S. Food and Drug Administration (FDA) for prophylactic treatment of chronic migraines in 2010. It has been shown effective in reducing the frequency of chronic migraine headaches, along with their severity.
How does Botox prevent migraine headaches?
Botox works by interrupting the release of pain-producing chemicals in the brain known as neurotransmitters. These chemical “messengers” are responsible for transporting signals between brain cells. Botox is absorbed into nerves, modifying or blocking their release.
We advise our patients that while Botox may help relieve the severity and frequency of migraine headaches, the medication does not alter the underlying condition that causes or triggers the migraine headaches.
What Can I expect with a Botox procedure?
During the Botox treatment for chronic migraine headaches, our doctors may use either a topical or injectable numbing agent over the skin or muscle site before the injection. Then, a very fine needle is used to inject the Botox into the skin or muscles. Very little discomfort is felt by our patients during this procedure.
Our doctors follow recommended protocols developed by the FDA for Botox-A injection therapy. Treatment includes injections given in a number of intramuscular sites that include the:
- bridge of the nose
- back of the head
- upper back (above the shoulder blades)
A continual, three-month interval between injections of Botox is recommended by our doctors in order to extend the benefits of the treatment.
The Mayo Clinic recommends that you do not rub or massage the area for 24 hours to prevent the Botox from spreading to other areas. You may begin to feel results within 24 to 72 hours, although it differs for every patient.
What about side effects?
While Botox treatments have proven effective in improving the quality of life for many suffering from chronic migraines, Botox is not recommended for everyone. According to medical studies, patients with comorbidity factors such as obesity, heart disease, asthma, or mental issues such as depression and anxiety must be carefully considered before treatment.
Risks associated with the injection treatment include the potential for muscle weakness or regional paralysis in the area. For some, mild irritation at the injection site may be experienced.
Get Treatment for Migraines Using Botox in Somerset and Hunterdon County
If you suffer from 15 or more migraines a month, it is time to discuss treatment options for medications that may provide prophylactic relief.
For additional information or questions, visit the Somerset Oral & Maxillofacial Surgery Group, providing care for patients in the Somerset and Hunterdon County area, to discuss your options using Botox for migraine relief.