Botox for migraine headache is one of the newer advances to come along within the last five years. Many people are familiar with Botox and usually the first question providers get is..”can you get rid of my wrinkles too??” Well..yes and no. Wrinkles in forehead, yes, around the eyes, you have to see the plastic surgeon for that one!
Botox for migraine headache is a form of botulism toxin that is extremely diluted. The injections are given in small amounts, about one tenth of a milliliter, and placed just under the skin, near the nerves that cause pain.
It also causes paralysis of the muscles in the area and is sometimes used for neck spasms known as dystonias, torticollis or “wry neck”. Sometimes this is also a part of the problem with migraine, as chronic spasms in the neck will cause headaches.
So where are the injections? The injections are placed across the forehead, and just between the eyebrows. They are always placed on both sides of the head, no matter on which side your headaches are frequent. After all, you would look pretty funny with lines on one side of your forehead and not the other, right? Injections are not placed past the midline of the eyebrow as that would paralyze the eyebrow (for a few months) and you would not be able to raise them. (There goes that look of surprise!) Additional injections are placed in the temporal muscles on both sides of the temple. If neck pain is a problem, then injections may be placed just under the skin in the neck.
Side effects of Botox injections include irritation at the injection site which may last a few days, and a minute amount of blood at the injection site. If given in the neck, weakness of neck muscles may be noticed but it is usually not severe. The success rate with Botox for migraine has been reported to be as high as 75%, but clinically many see about a 50% success rate.
Injections are given every 2-4 months depending on the patient and how soon the first set begins to wear off. Many insurance companies are beginning to pay for Botox for migraine and even for chronic daily headache, so check with yours to see if you qualify. If you don’t, the cost per session is about one thousand dollars and perhaps more depending on where you live.
So how do you know if you are a candidate for Botox for your headaches? Well you have to have severe headaches that have not responded well to other medications. Also, chronic daily headache or two or three disabling migraines per month would also be a good reason to consider Botox.
Botox does not cure headaches! Like many other medications for headache, Botox offers another medium for headache management. If successful, Botox allows may allow you to reduce, and perhaps eliminate, your other headache medications. Once you are stable, say one or two headaches per month, the Botox can be discontinued.
Talk to your provider, ask for a referral to a headache center to find out more about Botox for migraine.