Botulinum toxin injections are used not only in aesthetic medicine, but also for medical indications. One of the approved indications is the preventive treatment of chronic migraine in adults. Chronic migraine is defined as headaches occurring on at least 15 days per month, of which at least 8 days have migraine features.
Type A botulinum toxin is used to reduce migraine symptoms. Due to the preparation’s ability to block pain signals between muscle receptors and the brain, it may help reduce the intensity and frequency of migraine attacks. The injections are administered in the head, neck, and shoulder area.
Botulinum toxin type A therapy for chronic migraine has been used in Europe for more than ten years. It may be considered for patients with chronic migraine, especially when previous preventive treatment has not been sufficiently effective, has not been tolerated, or is not suitable.
When can botulinum toxin injections for migraine be appropriate?
Before the procedure, a consultation with a neurologist is required, during which the diagnosis of chronic migraine is confirmed and the suitability of this treatment is assessed. In the case of migraine, botulinum toxin is used as a preventive treatment method, not for stopping an acute migraine attack.
How is the procedure performed?
The procedure is carried out by a medical specialist with appropriate experience in administering botulinum toxin injections for medical indications. The preparation is injected in several small doses into specific anatomical points in the head and neck area. The standard protocol usually involves 31 to 39 injection sites. To maintain the effect, the treatment is usually repeated every 12 weeks, that is, about four times a year.
When does the effect appear?
The effect does not develop immediately. Improvement usually occurs gradually, and for some patients a more pronounced result is observed after repeated procedures. In some cases, a fuller effect is assessed after the second treatment cycle.
What should be observed after the procedure?
After the procedure, it is recommended not to rub or massage the injection sites and to avoid intense heat exposure and very heavy physical exertion for at least the first 24 hours. Mild tenderness, redness, bruising, or swelling at the injection sites may occur.
Possible side effects
The most common adverse reactions after botulinum toxin injections for migraine prevention are pain or tenderness at the injection sites, bruising, neck pain, or stiffness. Temporary muscle weakness may also occur in some cases. If unusual symptoms occur after the procedure, a doctor should be contacted.
When is the procedure not performed or when should it be assessed especially carefully?
The procedure is generally not recommended during pregnancy and breastfeeding.
Botulinum toxin injections must not be administered if there is a known allergy to the product or an infection at the planned injection site.
Special caution is required in patients with neuromuscular diseases associated with muscle weakness, such as myasthenia gravis or Lambert–Eaton syndrome.
Botulinum toxin therapy for the treatment of chronic migraine is intended for adults.
Important to know!
Botulinum toxin injections for chronic migraine are performed upon a neurologist’s referral. Before starting treatment, a doctor’s consultation is necessary to assess the diagnosis, previous therapy, possible contraindications, and the most appropriate treatment plan.
