Headache – this is one of the most common problems that every person faces from time to time. Stress, fatigue, weather changes, and a host of other factors can trigger headaches, which, in most cases, are fairly easy to fix. A much more serious problem is chronic migraine, and it is extremely difficult to find a truly effective method of treating it.
However, the Botox drug successfully copes with this problem, and the deputy director for scientific work of the Academician A.P. Romodanova, Head of the Chronic Pain Group, Doctor of Medical Sciences Beloshitsky Vadim Vasilievich.
Read an exclusive interview with a specialist right now.
How long have botulinum toxin preparations been used to treat chronic migraine?
The first reports of a positive effect of botulinum toxin on migraine date back to 1992.
Cosmetic surgeons in the United States have noticed that patients who have received Botox injections have experienced a reduction in the severity of headaches.
The effect was observed specifically in patients with chronic migraine. This attracted attention, and, subsequently, clinical trials were carried out, the results of which were reported in 2009 at the International Headache Congress. Even then, based on the results of a study conducted in more than 1300 patients, it was shown that headaches are effectively reduced after Botox injections. according to a special protocol developed in these studies.
What types of migraines can be treated with botulinum toxin?
V.B. Indication for the treatment of migraine with Botox is chronic migraine. This is a condition where headaches bother the patient for more than 15 days a month. Very often they become daily. We also often observe a condition where patients become dependent on analgesics and anti-migraine drugs. They develop what is called an overuse headache, or a headache associated with excessive use of drugs. Many patients with chronic migraine cannot tolerate ongoing medication to prevent attacks because the medications can have side effects. All such patients with chronic migraine should try Botox treatment.<
Due to what mechanisms of action does botulinum toxin help the patient get rid of headaches?
V.B. Currently, there are several explanations for the analgesic effect of botulinum toxin in chronic migraine. It is believed that botulinum toxin is captured by nerve endings and blocks sensory, that is, sensitive transmission. Thus, the pain impulse that is born in these neurons is not transmitted to the overlying centers. But there is another important mechanism in the development of migraine called neurogenic inflammation. Nerve endings are able to secrete certain substances that act on the vessels of the meninges and cause them to overfill and stagnate blood.
A lot of the unpleasant effects and sensations that the patient feels during a migraine attack are associated with this. It has been observed that botulinum toxin blocks the release of certain substances into the environment by nerve endings, such as substance P, a peptide associated with the calcitonin gene, and others. This leads to a decrease in neurogenic inflammation, and, as a result, to relief of the patient's condition.
What are the contraindications for the use of botulinum toxin in chronic migraine?
A contraindication for the use of botulinum toxin is, as for all other drugs, individual intolerance to the drug.
The usual contraindications are age under 2 years, pregnancy, lactation, inflammatory changes at the intended injection site.In all these cases, the use of botulinum toxin should be avoided, as well as being very careful when taking certain antibiotics from the aminoglycoside group, which can modify the effects of botulinum toxin, as well as antiplatelet agents and anticoagulants – drugs that reduce blood clotting. In such patients, hematomas may occur at the injection sites.
How long does the therapeutic effect last after the application of botulinum toxin?
On average, the therapeutic effect lasts three months, so standard protocols suggest repeat injections in patients with chronic migraine every three months. Sometimes we see longer effects - up to 4 months.
Beloshitsky Vadim Vasilyevich
Consultation by phone: +380 98 119 76 77
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