Migraine pain? Botox can bring welcome relief
“Botox stops a migraine in its tracks,” says 35-year-old Joseph, an attorney who has suffered from severe headaches since childhood. “It’s effective in making my migraines a lot less frequent and a lot less intense.”
“Botox injections helped me for six weeks,” says Haley, a 19-year-old college student whose migraines began at age 16.
Patients led doctors to study Botox’s effects on migraines
Plastic surgeons first learned of Botox’s effects on migraines when patients who got Botox for wrinkles suddenly reported that they weren’t having severe migraines anymore. That discovery has led to years of research.
According to a study published in the February issue of Archives of Dermatology, 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.”
Botox can help when medications fall short
“Most of my migraine patients are referred to me by neurologists,” says Dr. Rappaport. “These are patients whose migraines are not significantly improved by medications or ‘shotgun-approach’ Botox treatments.
Treating migraines involves a certain amount of guesswork, because what works for one patient may not work for another. Over the years, Joseph’s neurologist had prescribed everything from antidepressants to anti-epilepsy drugs. “I had terrible side-effects,” Joseph recalls. “The medications made me incredibly inarticulate. And in my line of work, that’s not good.”
Botox helps identify an individual’s migraine triggers
“I’m using Botox as a diagnostic tool to help find each patient’s migraine trigger points,” Dr. Rappaport explains. “By injecting Botox in strategic areas at intervals, we can rule out the muscles that are not causing a patient’s migraines and identify the ones that are. We don’t offer a cure, but we can offer migraine patients a better quality of life.”
Migraine trigger points may be found around the eyes, at the temples and at the back of the neck. By relaxing specific muscles, Botox can help prevent them from squeezing on nearby nerves and triggering migraines.
Surgery can offer a long-term solution
Ten years ago, patients of Cleveland plastic surgeon Bahman Guyuron, MD, reported that their migraines improved after a forehead lift. This led him to look for a surgical solution to address migraine trigger points.
In Dr. Guyuron’s double-blind study, published in the August 2009 issue of Plastic and Reconstructive Surgery, 80% of patients who had surgery in one of three “trigger sites” had significantly fewer headaches, compared with 55% of the group who had sham surgery. More than half of the patients who had the real surgery said their headaches were completely eliminated.