Suffering from migraines?
BOTOX® can relax the muscles
that trigger them

You know BOTOX® can help smooth out your facial wrinkles—but did you know it can help prevent migraines?

• BOTOX® relaxes key muscles in the face and neck—preventing them from squeezing on nerves
• BOTOX® can reduce the frequency and intensity of migraines
• Relief can last from six weeks to a lifetime (with repeated injections)

BOTOX® can address 3 major migraine trigger points:

• Around the eyes
• At the temples
• At the back of the neck

“Most of my migraine patients are referred to me by their neurologist,” says Dr. Rappaport. “These are patients whose migraines are not significantly improved by medications or ‘shotgun-approach’ BOTOX® treatments. We don't offer a cure, but we can offer migraine patients a better quality of life.”

Where are your migraine trigger points?

Each person's migraines are due to specific causes, which vary from one patient to the next. In some cases, muscles in the face or neck may tighten and impinge on sensitive nerves, resulting in severe headaches. The question is, are certain muscles triggering your migraines?

“I use BOTOX® as a diagnostic tool to help find a patient's migraine trigger points,” says Dr. Rappaport. “Using BOTOX® prevents muscles from squeezing on sensitive nerves—and causing migraines. By injecting BOTOX® in strategic areas at intervals, we can rule out the muscles that aren't causing a patient's headaches.

“Relaxing facial muscles with BOTOX® not only gives you an aesthetic improvement, but helps minimize the pain of migraines,” he explains.

Discovering the connection between facial muscles and migraines

BOTOX®'s migraine-preventing potential wasn't discovered through scientific research. It came from plastic surgeons' observations of patients who actually had forehead/brow lift surgery with removal of the corrugator muscles—the same muscles treated by BOTOX®. These patients noticed that their migraines had decreased in frequency and intensity.

Although this discovery didn't come from clinical studies, it has resulted in several:

• A study in the February 2010 Archives of Dermatology, published by the American Medical Association, found that BOTOX® may reduce the frequency of “imploding migraines,” described as crushing, vice-like or eye-popping—but not pain experienced as a buildup of pressure inside the head, known as “exploding migraines.”
• In research presented at the 2003 American Headache Society Annual Meeting, 80% of migraine patients treated with BOTOX® every three months said their headaches were less frequent, less intense or both; 60.5% reported good to excellent pain relief.

Surgical migraine treatment offers a long-term solution

Years ago, patients of Cleveland, Ohio plastic surgeon Bahman Guyuron, MD, reported that their migraines improved after having a forehead lift. This discovery led Dr. Guyuron to look for a surgical solution to address migraine trigger points.

Dr. Guyuron's double-blind clinical study was published in the August 2009 issue of Plastic and Reconstructive Surgery. He found that 80% of migraine patients who had surgery in one of three “trigger sites” had significantly fewer headaches—compared with 55% of the control group who had sham surgery. More than half of the patients who had the real surgery said their headaches were completely eliminated.

“I have been working in concert with neurologists for many years as a result of Dr. Guyuron's studies and my personal communications with him,” says Dr. Rappaport. “He is a friend and colleague.”

‘BOTOX® found the muscles that triggered my migraines’

Haley, a 19-year-old college student who came to Dr. Rappaport for BOTOX® migraine treatments, had surgery when they discovered that her daily migraines were caused by specific muscles at the back of her neck.

“The BOTOX® treatments were very effective for six weeks, but then they wore off,” she recalls. “I couldn't keep getting BOTOX® treatments every six weeks, so I chose surgery.

“I had surgery on the right side last August,” Haley explains. “Dr. Rappaport cut through the two layers of muscle right above the occipital nerve and then went in to where the muscle joins with the nerve and separated them so there's no pressure on the nerve—and that relieves the headaches.

“I've had only a few headaches in the eight months since the surgery, and I used to get them every day,” she says. “I'm planning to have surgery on the left side when I get back from school in May.”