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“This is because Botox is injected into the muscle and not distributed into the blood stream,” said Dr Eric Eross of the Headache and Facial Pain Institute in Arizona, which reported dramatic improvement in sufferers after injections to their forehead and brow muscles.
He conceded, however, that we still do not know exactly why Botox has this effect, though it’s suspected that it works because it interferes with the transmission of nerve pain signals.
Mild pain during the injections is the only frequent side effect.
Todd Troost, a researcher from Wake Forest University Baptist Medical Centre, found a success rate as high as 92% with migraine patients using Botox. When it works to relieve pain, he finds, it also reduces the need for other medications.
How the studies were conducted
In his study, at the Mayo Clinic in Arizona, HealthScout reports that Eross evaluated 48 patients with chronic migraine, and administered anything from 25 units to 100 units of Botox - more than the typical cosmetic-surgery patient gets - at several sites, including the forehead, temples and sometimes the back of the neck and the shoulders.
Most of the patients in the study were also on migraine medication, both those designed to work preventively and those used for acute attacks, Eross says. But "we do have a handful of patients who were just on Botox."
Three months after the injections, patients responded to a disability evaluation instrument, called the MIDAS, usually used by researchers to evaluate disability. Patients were asked how or if the Botox made a difference in whether they had lost work days, social commitments and other effects of headache pain.
Eross found that 58 percent of the patients had a 50 percent or greater reduction in disability. The average decrease in headache frequency was 61 percent; in severity it was 27 percent, and in disability it was 79 percent. "If you get an agent (a medicine for headache pain) that helps with 60 percent, you are doing good," Eross says.
Researchers do agree that more studies are needed before Botox becomes the application of choice for headaches.
(Robyn von Geusau, Health24, updated July 2007)
