What is Migraine?
Migraine is a very common problem, affecting approximately 1 in 7 people. It most commonly presents between the ages of 35-45 and is three times more common in women compared to men.
Migraine is a disorder that in many cases is genetically inherited, with a positive family history in most.
Migraines can present differently from person to person. It is a complex condition with the main symptom being a painful headache. Other common symptoms include nausea, vomiting, and sensitivity to light and sound. In some, there may be visual symptoms such as temporary, partial loss of vision or disturbances in colour perception. Certain triggers can bring on a migraine attack in a susceptible person. Common triggers include stress, tiredness, hunger, lack of sleep and loud noises or flashing lights etc.
At present, unfortunately, there is no definite cure for migraines.
Botox® (Botulinum Toxin) injections for chronic migraines
Botox® was granted the licence to treat chronic migraines in 2010 by the MHRA in the UK. Botox ® is a muscle relaxant.
It has been popular in aesthetic medicine in reducing frown lines and crow’s feet, but has also been used in medicine to treat excessive sweating (hyperhidrosis), blepharospasm, squints, dystonia etc.
In patients with chronic migraines, Botox® injections are placed at fixed sites and given at fixed intervals of every 12 weeks. The amount of toxin injected is roughly double the amount used for wrinkles on the face. Over ¾ of patients in the trial had fewer than half the number of headache days each month compared to usual. Keeping a diary can be really useful in assessing whether the treatment works for you.
Side effects are not that common with less than 10% of patients suffering any side effects. The most common side effect is neck pain and muscle weakness. Other side effects that have been described and include nausea, dizziness, blurred vision, and weakness in the neck muscles specifically.
How long does it take to work in migraines? It can take 2-3 treatments carried out every 12 weeks for Botox® to work in chronic migraines, so don’t give up too early.
For less severe migraines, tension headaches and stress related headaches, there are a fair amount of anecdotal reports to suggest toxin injections in the frown and forehead areas can be beneficial, the cost for this is the same as Botox® for treatment of wrinkles in these areas.