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Botox‐A for Suppression of Chronic Migraine: Commonly Asked Questions
Author(s) -
Rothrock John F.
Publication year - 2012
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2012.02121.x
Subject(s) - medicine , chronic migraine , migraine , forehead , injection site , food and drug administration , head and neck , anesthesia , surgery , environmental health
1. How many injections does each treatment involve, and what are the areas injected? The protocol for use of Botox-A injection therapy for treating chronic migraine is based upon the clinical research studies that earned the treatment its FDA approval and subsequent guidelines provided by the FDA. Each treatment involves 31 injections (5 Botox-A units per injection, for a total of 155 units). Areas injected include the bridge of the nose, the forehead, the temples, the back of the head, the neck, and the upper back (just above the shoulder blades). 2. Does it hurt? A very small, very sharp needle is used to perform the injections, and the injection process itself is not especially painful. Botox-A mixed with saline (salt water) can produce a brief burning sensation at the injection site. When treatment is performed by an experienced injector, the entire process requires no more than 10-15 minutes and is typically well tolerated. Immediately after the treatment, the vast majority of patients are able to return to their routine daily activities. 3. When can I expect improvement? Especially with the first set of injections, any improvement in your headache disorder may be delayed for as long as 10-14 days. A number of patients who fail to experience any improvement following their first Botox-A treatment may respond quite well when treatment is repeated. Even so, patients who note no improvement in their headache disorder after 2 (or perhaps 3) treatments are unlikely to become responders if treatment is continued. 4. What are the potential side effects of Botox-A injection therapy for chronic migraine? While Botox-A is a remarkably “clean” treatment for the prevention and suppression of headache, side effects can occur. The most common of these is neck pain and stiffness, often accompanied by what has become known as “wobbly neck” or “bobble head.” Injection of Botox-A into the muscles of the neck and upper shoulders may cause temporary partial weakness in those muscles, and the pain and stiffness Headache © 2012 American Headache Society Published by John Wiley & Sons, Inc. doi: 10.1111/j.1526-4610.2012.02121.x