Botulinum Toxin Type A injections may be able to prevent (imploding and ocular) migraine

January 01, 0001

Botulinum Toxin Type A injections may be able to prevent (imploding and ocular) migraine

Botulinum toxin type A (BTX) is used prophylactically to reduce the frequency of migraine headaches, with inconsistent responses reported in the literature. The purpose of this study was to determine whether BTX injections at doses used for upper-face cosmetic purposes, which differ from doses typically used by headache specialists, could prevent imploding and ocular but not exploding migraines. Study participants were recruited among patients who had received or were planning to receive BTX injections for upper-face cosmetic purposes but also reported having migraines.

Among the 18 patients who completed the study, most with imploding and ocular migraines experienced a significant reduction in their headache frequency, whereas those with exploding migraines generally did not.

The researchers concluded:  "Our study supports the hypothesis that patients with imploding and ocular migraines are more responsive to BTX than those with exploding migraines. Injections of BTX at doses appropriate for cosmetic purposes may be sufficient to prevent migraine attacks."

Interesting small study with some methodological issues. Subsets of migraine will require more accurate identification.

For the full abstract, click here.

Arch Dermatol February 2010;146(2):159-163
© 2010 American Medical Association
Predicting Migraine Responsiveness to Botulinum Toxin Type A Injections. Christine C. Kim, Megan M. Bogart, Sue Ann Wee et al.

Category: N. Neurological. Keywords: predicting, migraine, responsiveness, botulinum Type A, injections, cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 9 April 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.