Botulinum therapy for headaches

How botox works

Migraine is a common disease that affects up to 30% of the world's population. At least once in a lifetime, about 25% of all women and up to 10% of men have experienced this unpleasant headache. The high prevalence has influenced the search for effective and safe agents that can help with this disease.

Botox (Onabotulinumtoxin A) stands out among them. This drug belongs to a group of neuroproteins suitable for the preventive treatment of chronic migraine. It has proven efficacy and safety. In Russia, the use of botox to combat headaches is allowed. The drug is listed as a remedy for relieving the symptoms of pain and migraine.

The action of botox in the treatment of headaches is to relax spasmodic muscles, blocking the transmission of substances responsible for activating the pain center in the brain. Once in the body, the toxin blocks the work of transport proteins that carry acetylcholine (responsible for the transmission of neuromuscular impulses to calcium channels). As a result, muscle contractions stop, pain associated with muscle spasm is eliminated.

It is important to note that a severe headache with precise localization may not be caused by a spasm in the muscles, but by a violation of the tone of the vessels that feed the brain (the exact cause is determined during diagnosis, in particular, by performing ultrasound of the vessels). In such cases, botox for migraine is an adjuvant. The main therapy remains drugs that affect the tone of the vascular wall, bringing it back to normal.

Botulinum therapy is an injection of type A botulinum toxin preparations (dysport, xeomin, botox) for the treatment of spasticity after a stroke, muscular dystonia, pain syndromes, involuntary facial muscle contractions, and perspiration disorders.

Botulinum toxin has been used in the treatment of neurological disorders for more than 20 years, and during this time it has established itself in practice as a safe and effective remedy.

"Mysterious molecule of the century" - this is how the world neurological community called botulinum toxin in 2000.

The neurologists of our center perform injections of botulinum toxin preparations under the control of electromyography, that is, using an electroneuromyograph to analyze the accuracy of the injection needle insertion. This makes it possible to determine the target muscles for botulinum toxin injections, which contributes to an increase in the therapeutic effect.

When administered locally in therapeutic doses, botulinum toxin does not penetrate the blood-brain barrier and does not cause significant systemic effects. In terms of human health effects, botulinum toxin injections are much less harmful than most pills.

The practice of botulinum therapy has existed for decades. During this time, millions of people around the world have received treatment. Therefore, we can say with confidence that of all the drugs used for the treatment of dystonia and spasticity, botulinum toxin preparations implement the main principle - do no harm to the patient.

Depending on the disease, the effect of botulinum toxin begins to manifest itself within 2-3 days after administration and reaches its peak after 7-12 days. Duration of effect: from 4 months to a year. More than 90% of patients are satisfied with the result.

Scope of application of preparations based on botulinum toxin

Botulinum toxin preparations are becoming a valuable drug in the treatment of patients with tension headaches and chronic migraines.

Botulinum toxin is actively and successfully used by neurologists of our center in the treatment of myofascial pain syndromes (shoulder-scapular periarthropathy syndrome, upper chest aperture, back pain, tennis elbow, myofascial facial pain syndrome, fibromyalgia, etc.).

Botulinum toxin injections are used in the treatment of blepharospasm, spastic torticollis, and also relieve pain syndromes in tunnel (compression-ischemic) neuropathies of peripheral nerves.

In recent years, the most popular method of treating local hyperhidrosis all over the world has become the intradermal administration of botulinum toxin.

Botulinum toxin can be used to treat all types of local hyperhidrosis, including such rare forms as hyperhidrosis of the face, head, and groin.

Other medicinal techniques

The drug erenumab is a monoclonal human antibody to the CGRP receptor (the receptor responsible for migraine headaches). Erenumab is well tolerated and has no contraindications for use.

The drug allows:

  • Reduce the severity of migraine attacks and reduce the frequency of their occurrence (reduction of attacks by up to 70% with a 6-month course of treatment).
  • Reduce the number of days of pain by 2 times.
  • At least halve the use of pain medications.

Contraindications

Botulinum therapy for headache in neurology has a number of contraindications:

  • Infectious or bacterial skin lesions at the injection site of botox.
  • The period of exacerbation of chronic diseases.
  • SARS.
  • Individual intolerance to botox.
  • Lack of improvement on the background of ongoing treatment.
  • Autoimmune diseases that affect the muscles.
  • Diagnosed damage to the cells of the brain and spinal cord.
  • Taking antibiotics.
  • Children's age (botulinum toxin therapy is prohibited for patients under 18 years of age).

There is no exact data on the possibility of using botox for headaches during pregnancy and lactation, due to an insufficient number of studies.

How is botulinum therapy performed?

Botulinum therapy refers to injection methods for the treatment of migraine. Patients suffering from headache, with the help of an insulin syringe, from 160 to 200 IU of the drug is injected into one or more areas:

  • Bridge of the nose.
  • Brow ridges.
  • Whiskey.
  • Above and suboccipital region.
  • The trapezius muscles in the neck.

The injection site of the botox preparation and the volume of the dose are calculated by the doctor individually, taking into account the nature and severity of the headache, its causes and other factors identified during the examination at the clinic. Botulinum therapy is a painless treatment for headaches. If desired, the patient may use local anesthesia in the area of injection.

What are the effects of botox injections?

As a primary therapeutic and prophylactic method for the treatment of headaches, botulinum toxin therapy can achieve the following results:

  • Reduction or complete elimination of pain syndrome.
  • Reducing the frequency and intensity of migraine.
  • Increased patient activity (migraine impairs quality of life and often causes chronic fatigue).
  • Reducing the number of pain medications you take.

Timely contacting the clinic and the therapy started can prevent the development of muscle tension syndrome, neuroses and other migraine-related diseases (depression, anxiety, panic attacks). The solution to the headache problem is complex, often supplementing the administration of the drug with manual therapy and massage, aimed at eliminating nerve endings and blood vessels in the cervical spine by clamping.

Depending on the severity of the headache, a noticeable effect of therapy is observed after 1-3 procedures. The classic scheme involves the procedure every 3 months (the period may vary depending on the patient's metabolism).

Are there side effects

Taking into account the individual anatomical features of the patient, the side effects of migraine treatment with botox may vary:

  • Microhematomas and slight pain at the injection site.
  • Weakness of the neck muscles.
  • Slight drooping of the eyelids (disappears within 2-3 weeks).

The listed side effects are manifested on average in 10-25% of patients in the clinic, they are unexpressed and inconsistent.

Service record



Specialists

All specialists
Melitmayer
Tatyana Valeryevna

Head of the department of neurology and psychotherapy, neurologist

Stepanyan
Mushegh Agoevich

Neurologist, neurosurgeon

Doctor of Sciences, PhD

Osipova
Vera Valentinovna

Neurologist-cephalologist

Doctor of Sciences, PhD

Nodel
Marina Romanovna

Neurologist, consultant

Doctor of Sciences, PhD, professor

Huseynova
Kamila Timurovna

Neurologist, reflexologist

Tatarenko
Alena Igorevna

Neurologist, parkinsonologist

Burd
Sergej Georgievich

Neurologist-epileptologist

Doctor of Sciences, PhD, professor

Omarova
Sabina Magomedovna

Neurologist, parkinsonologist

Bogdanova
Inna Sergeevna

Neurologist, otoneurologist, somnologist

PhD