BOTULINUM TOXIN FOR TREATMENT OF MIGRAINE HEADACHES – A STUDY FROM TERTIARY EYE CARE CENTRE

Background - Migraine is one of the common causes of recurrent headaches. Botulinum toxin type A (Botox®) is a neurotoxin produced by Clostridium botulinum that paralyzes nerves. The purpose of this study was to evaluate the efficacy of pericranial Botox® administration in migraine headache in patients attending a tertiary eye care centre. Method - A prospective,non-randomized study consisting of 54 patients was performed.Subjects were candidates who either sought Botox® treatment for hyperfunctional facial lines with concomitant headache or candidates for Botox® treatment specifically for headaches. Headaches were classified based on International Headache Society criteria. Botox® was injected into the glabellar,temporal,frontal,and/or suboccipital regions of the head and neck.Patients were treated every three months,with a maximum of three sessions.Botox dosage ranged from 75 - 155 Units per patient.Main outcome measures were relief from migraine headache symptoms, reduction of headache severity and duration of symptom free period. Results - Age ranged from 18 to 65 (mean 34.6±6.5) years. Among 54 subjects treated prophylactically,complete response (symptom elimination) was noted in 31 (57.40%) with a mean {Standard deviation – (SD)} response duration of 4.3 (2.4) months; 16 (29.62%) reported partial response (≥50% reduction in headache frequency or severity) with a mean (SD) response duration of 2.5 (1.7) months. 7 (12.96%) reported no response. No systemic adverse effects were reported.Conclusion - Botox® is found to be a safe and effective therapy for prophylactic treatment of migraine.