Anyone who regularly suffers from migraines knows how much they can restrict everyday life. Both professionally and privately. Those affected describe the usually very severe headaches as throbbing, often on one side, accompanied by sensitivity to light, nausea or dizziness. The exact „pain pattern“ varies from person to person. If the headache occurs several days a month, we speak of a chronic migraine. Classic painkillers often reach their limits here. Botulinum is a promising therapy concept.
When migraines become chronic
We speak of chronic migraine when headaches occur on at least 15 days a month, at least 8 of which are accompanied by the typical migraine symptoms. Migraine is a disease that affects the sensation of pain itself and the processing of nerve stimuli.
Those affected often report that the medication is not effective enough, is poorly tolerated or does not bring any stable improvement in the long term.
How botulinum works for migraines
Perhaps you know botulinum toxin from aesthetic medicine? At the Swiss Derma Clinic in Zurich, for example, we treat wrinkles or drooping eyebrows with the muscle-relaxing substance(read more). The active ingredient has also been used successfully in neurology for many years.
The mechanism of action? It is completely different from that of classic painkillers. Botulinum toxin blocks the release of certain messenger substances at the nerve endings that are involved in pain transmission. The overactivity of the pain-mediating nerve pathways is weakened.
Important: Pain is not pushed away, the transmission of stimuli within the nervous system is calmed.
A look at the treatment
The therapy is carried out in defined areas of the head, neck and shoulders. Botulinum toxin is injected in very small quantities into specific muscle and nerve regions. Similar to an injection with fine needles and within a few minutes. Anesthesia is generally not necessary – there is also no downtime.
The effect of botulinum toxin does not start immediately; it develops continuously over one to two weeks.
Who is the treatment suitable for?
Botulinum toxin is only approved for the treatment of chronic migraine. It is not approved for the treatment of occasional or episodic migraines. The most important prerequisite is therefore an appropriate diagnosis by a neurologist.
| Important regulations: Botulinum toxin for chronic headaches
The use of botulinum toxin for chronic migraines is subject to strict regulations and always requires a specialist diagnosis and assessment by a neurologist. People with many migraine days per month, for whom prophylactic therapies do not work sufficiently and who have problems with medication-related side effects, are particularly likely to benefit. The risk of side effects is very low when used by a specialist. Small, temporary bleeding in the area of the puncture sites is possible. In some cases, local tenderness or a feeling of tension may occur in the treated area. |
Botulinum toxin: part of a holistic concept?
Migraines are complex. Treatment with botulinum toxin does not automatically replace other options; instead, it is part of an individualized overall concept. This includes, for example
- adapting your lifestyle
- Less stress, fewer migraine triggers
- Accompanying medication
- Sport or relaxation techniques
Botulinum toxin can be an effective treatment option if you have been proven to suffer from chronic migraines. The treatment is not an immediate solution, but an approach that is designed for long-term prevention. Whether this is also suitable for you can only be assessed during a specialist consultation.
Botulinum toxin – briefly explainedBotulinum toxin is a medical agent that has been tried and tested for many years. It can temporarily dampen certain nerve impulses and thus relax overactive muscles. Pain-conducting stimuli are reduced. In migraine therapy , the muscle relaxant calms hypersensitive nerves that are involved in the development of chronic headaches. The effect of botulinum toxin is temporary and completely reversible. The active ingredient is broken down by the body after a few months. The treatment should be carried out by an experienced doctor and requires extensive specialist diagnostics. |
FAQ
When does migraine treatment with botulinum toxin make sense?
This approach is aimed at patients with chronic migraines (at least 15 headache days per month over a period of at least 3 months). The prerequisites are a specialist (neurological) diagnosis and previous treatment with conventional medication.
How quickly does botulinum toxin take effect in migraines?
The active ingredient is a muscle relaxant that does not have an immediate pain-relieving effect, such as a painkiller. It has a preventative effect and influences the activity of pain-conducting nerves. The effect builds up gradually over a period of around two weeks after the injection and lasts for around three months. A single acute attack cannot be treated with botulinum toxin. For a stable improvement, regular treatments at fixed intervals are advisable.
Does the treatment have to be permanent?
Long-term treatment is not absolutely necessary. Many patients benefit from the therapy for a certain period of time and then no longer need it as their condition has stabilized. Others only need treatment in phases. What makes sense depends on the individual course of the migraine.
