BOTOX® for Migraine
By Deena E. Kuruvilla, MD; Brooklyn A. Bradley, BS
BOTOX® has brought relief to many people with chronic medical conditions [1]. Botox is FDA approved for people aged 18 and older who experience chronic migraine and experience 15 or more headache days each month [1,2].
Licensed medical professionals treat migraine by injecting botulinum neurotoxin (BoNT) into various areas around the head and neck, every 12 weeks. The injections should be administered in your doctors office by a headache specialist or neurologist who has been trained and certified during their fellowship. Botox is also used for other medical conditions such as blepharospasm, cervical dystonia, overactive bladder and hyperhidrosis. BoNT works several ways to mediate pain pathways. It is able to relax the muscle because it blocks the release of acetylcholine at the neuromuscular junction. BOTOX® is injected around pain fibers that are typically involved in migraine [1]. Once the BOTOX® enters the nerve endings and blocks the release of acetylcholine at the neuromuscular junction, it prevents the activation of pain networks in the brain [1]. In addition to targeting muscle, Botox has been found to block inflammatory factors which produce migraine such as calcitonin gene-related peptide, substance P and neurokinins. In clinical trials, botox was found to give people with chronic migraine a 50% reduction in pain frequency and severity [3]. This is the average response seen in the real world as well.
Temporomandibular dysfunction is commonly seen with migraine and can produce severe jaw pain, difficulty eating and opening the mouth and grinding the teeth. BOTOX® can be an extremely effective treatment for the treatment of both chronic migraine and temporomandibular dysfunction. In a 2016 study, researchers found that the injection of 21 units of BOTOX into the masseter and temporalis muscles significantly improved symptoms for patients [4].
In a survey, 92% of current BOTOX® users stated that they wished they had spoken to their doctor and started BOTOX® treatment sooner [5]. It is important to discuss this treatment with your neurologist or headache specialist to learn more about this type of therapy and the benefits it can provide for migraine and jaw pain. Overall, the goal of BOTOX® for migraine is to reduce the frequency of migraine.
Botox is a key treatment we provide and we look forward to answering any questions you have! – Dr. K
References:
- “Botox for Migraine.” American Migraine Foundation, https://americanmigrainefoundation.org/resource-library/botox-for-migraine/. Accessed 24 Feb. 2023.
- Botulinum Toxin Injectables for Migraines. 15 Oct. 2021, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/botulinum-toxin-injectables-for-migraines.
- Dodick, David W., et al. “OnabotulinumtoxinA for Treatment of Chronic Migraine: Pooled Results from the Double-Blind, Randomized, Placebo-Controlled Phases of the PREEMPT Clinical Program.” Headache, vol. 50, no. 6, June 2010, pp. 921–36. PubMed, https://doi.org/10.1111/j.1526-4610.2010.01678.x.
- Botulinum Toxin Injectables for Migraines. 15 Oct. 2021, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/botulinum-toxin-injectables-for-migraines.
- Do, T. P., et al. “Botulinum Toxin: A Review of the Mode of Action in Migraine.” Acta Neurologica Scandinavica, vol. 137, no. 5, May 2018, pp. 442–51. PubMed, https://doi.org/10.1111/ane.12906.