Patients who responded to Botox saw their migraines reduced from almost seven days a month to less than one day a month. Among those with exploding migraine, headaches were reduced from 11.4 days a month to 9.4 days a month.
Why Botox, which paralyzes muscles, reduces migraine isn't clear, the researchers said. It may work by blocking pain receptors or reducing inflammation, they noted.
"While our results are preliminary, we are hopeful that our findings may eventually help researchers determine how botulinum toxin A injections prevent migraine pain, which patients will respond favorably, and what the proper doses and injection locations should be," Kim said.
The study was funded in part by Allergan Inc., the maker of Botox.
Botox has been tested before as a treatment for migraine, but was found wanting. In 2008, guidelines from the American Academy of Neurology said Botox should not be used to treat migraine because there was no evidence that it was beneficial.
"While Botox is not a first-line therapy for migraine prophylaxis, more research in this area may reveal that it can work to treat a unique portion of the migraine-suffering population," Kim said. "Botox is not considered the standard of care for preventing migraines, but it may be an alternative for some patients who do not respond to standard prophylactic medications."
Dr. Richard B. Lipton, vice chairman of neurology and director of the Montefiore Headache Center at the Albert Einstein College of Medicine in New York City, agreed: "Some migraine patients respond to treatment with botulinum toxin very dramatically, while others do not respond."
"Identifying the migraine patients who respond to toxin has long been a holy grail in headache medicine," he added.
Though this study is small, when combined with other evidence, it strongly supports the idea that patients with imploding headache respond to Botox treatment,
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