Botulinum toxin for migraine: relief for chronic headaches

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 explained Botu­li­num 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.