Botox may offer relief for chronic migraine sufferers

April 20, 2016 Providence Health Team

Botox, a type of botulinum toxin often used cosmetically for aging, is effective in treating chronic migraine, according to new updated guidelines from the American Academy of Neurology. The guidelines are based on a review of scientific studies led by Dr. David Simpson of the Icahn School of Medicine at Mount Sinai in New York City.

The research team concluded that the treatment is generally safe and effective for some neurological conditions, including chronic migraine, which affect more than 37 million people nationally.

How treatment works

Botox is made by a specific type of bacteria. While four preparations of botulism toxin are available on the U.S. market, only Botox (onabotulinum toxin A) was found to help reduce how often migraine headaches occur. Researchers say that it helps prevent substances from being released at nerve endings and reduces muscle contraction and pain-signal transmission.

For migraine treatment, patients receive multiple injections of Botox around the head and neck every 12 weeks. The new guidelines indicate that Botox is most effective for people with migraine headaches occurring more than 14 days a month. When compared to the placebo, Botox reduced headaches by 15 percent a month.

The guidelines suggest that Botox may also be helpful for other disorders, including limb spasticity.

What causes migraine headaches?

No one really knows what causes migraine, although researchers believe they may be linked to genetics, environmental factors, and nerve and blood vessel abnormalities. Despite a gap in knowledge, there are known triggers. Many foods trigger migraine headaches, according to the National Institutes of Health. They include:

  • Processed, fermented, pickled or marinated foods, as well as those with MSG
  • Baked goods, chocolate, nuts and dairy products
  • Fruits such as avocado, banana and citrus fruit
  • Meats with sodium nitrates including bacon, hot dogs, salami and cured meats
  • Red wine, aged cheese, smoked fish, chicken liver, figs and certain beans

Other causes of migraine headaches include alcohol, smoking, stress, hormonal changes, loud noises and bright lights.

What to do when you get a migraine

The National Institutes of Health suggest that when you get a migraine headache, treat the symptoms as soon as possible. Here are some tips:

  • Drink water
  • Rest in a quiet, dark room
  • Place a cool cloth on your head

Acetaminophen, ibuprofen or aspirin can be helpful when your migraine is mild. However, it’s best to check with your health care provider before taking any medication. Your neurologist can recommend medications that will be most effective and safe for you.

When your headache might be an emergency

According to some studies, people with migraine may be more prone to ischemic stroke. For that reason, it’s even more important for individuals with migraine to know the signs of stroke and what to do if they suspect stroke or another serious neurological condition.

F.A.S.T is an acronym that can help you remember how to detect stroke. It stands for face drooping, arm weakness, speech difficulties and time. Time is part of the acronym to remind individuals that time is critical when it comes to treating stroke.

Since migraine can be so severe, it’s sometimes hard to know when to go to the emergency room. Call 911 if you:

  • Experience the "worst headache of your life"
  • Sudden headache with nausea, vomiting or altered mental state
  • Have speech, vision or movement problems, or lose your of balance, especially if you have not had these symptoms with a migraine before
  • Feel a headache start suddenly

Call or see your doctor if you:

  • Find your headache patterns or pain changes
  • Discover that treatments that once worked for you are no longer effective
  • Have side effects from your medicine
  • Are pregnant or could become pregnant as some medicines shouldn’t be taken during a pregnancy
  • Must take pain medications more than three times in a week
  • Take birth control pills and have migraine headaches
  • Find your headaches are more severe when lying down

If you have migraine and need treatment, find a neurologist or other provider near you.

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