I have chronic migraine with aura. And they have become daily. This is not cool. Not cool at all. I don’t respond well to preventative medications and so one option is botox for migraine. It is a treatment for chronic migraines (15 or more migraines a month).
Botox is a neurotoxin, a poison made by bacteria called Clostridium botulinums. It can cause a deadly reaction called botulism if you eat it in spoiled food because it blocks signals from your nerves and paralyzes your muscles.WebMD
The studies suggest botox for migraine can reduce the frequency or intensity of migraine attacks
In a study of adults who get chronic migraine headaches, shots of Botox cut down the total number of days they had them or even other types of headaches. They also had more “crystal-clear” — pain-free — days each month, and they reported fewer days off work.
In another study, nearly half the people who took two rounds of Botox shots reported that the number of days they had a headache each month was cut in half. After five rounds of treatment, that increased to about 70% of the peopleWebMD
It is 31 shots around the forehead area, along the side of the head, the base of the skull, shoulder area… but not the neck (due to the effects of botox).
My experience with migraine botox
So getting needles in the head is decidedly unpleasant. Who would have thought it?
But I’m not afraid of needles or minor fleeting pain.
I am no sissy girl.
Okay, I did cry a little and there was some begging for mercy, but other than that, super cool.
Actually, it is unpleasant, but not so unpleasant it is not bearable. The needles are very thin and so that makes it quite tolerable. Just if your scalp is sensitive due to allodynia (skin pain due to migraine… like a burning pain or your hair hurts… then it is irritating to get poked with a needle)
So looks like I am going to have a numb forehead for six months. But that isn’t necessarily so. It may be this is the reaction I had This time but maybe it is just this time. As usually, one does not get this numb feeling throughout. Just lucky I guess.
Even if you scare the bejeebers out of me, I will not look surprised. The neuro warned me explicitly not to rub my head in the next 24 hours, or a might push the botox down and thus have an eyelid drooping for three months… not a sexy look on anyone really. And this makes me a little paranoid about sleeping… given I smoosh my head into the pillow and toss and turn erratically all night long. I just might wake up with drooping eyelids and an ear at my chin.
The neuro said we should see results in two weeks, although I should see some change by the time I go back to work. He said it works on 3 out of 4 people, although not everyone can afford it (400 bucks a treatment and even I’m not sure if I will see a refund). Of those that see a result 25% will be migraine free for the three-month duration, while others have varying results. So I can anticipate some sort of positive result, although I don’t think so much for the hormonal migraines. Depending on the results we might have to change my painkiller because Toradol so does not do much on acute migraines and seriously not so good on the tummy.
Anyway, as it kicked in I did lose my Spock eyebrow and that rather irked me. Since that is something I use in everyday expressions. And now my eyebrows are rather inert. So irksome.
That didn’t happen any other time I did botox so perhaps it just sank down a little too low that time. It does weaken that eyebrow… so still not Much of a Spock eyebrow but not a frozen eyebrow either.
I can say one thing about botox for migraine prevention. It certainly does not work right away. I am not about to give up hope that it will work, but let’s just say so far I have been enduring three days of nasty migraines. If you say 10 is the worst migraine I have ever experienced, then I have been on average a 7.5 these last three days… well beyond functioning. So no decrease in intensity so far nor even frequency.
I have been told one does typically have to wait 3 rounds to see if it will make any difference to chronic migraine in intensity or frequency of migraine
If you are curious how getting a neurotoxin injected into your head muscles, rather than say directly into the brain, would have any effect on migraines there is actually no clear answer. I can understand how certain drugs affect migraines… affect the excitation of neurons firing and then the inflammation of blood vessels. But botox? Don’t get it. Maybe for tension headaches. Anyway here is what I found about the how:
“Why does it work?Based on the mechanism of action of Botox, it is unlikely that anyone would have thought to try it for migraines. Its success in treating some patients has caused problems for those who would attempt to explain why it would work in migraine. One possibility is that muscle tension may act as a trigger for migraine in the same way that light and odors do. By reducing muscle tension, Botox would be eliminating an irritant to the nervous system, which would then reduce the chances of a migraine developing. More recently, studies have shown that Botox may affect other nerve cell signalling systems that have to do with the perception of pain. In an animal model of pain, injection of Botox under the skin resulted in decreased response to painful stimuli. Traditionally, scientists have thought that the pain of migraine was due to swelling and inflammation of blood vessels, but perhaps muscle tension is more of a factor than previously appreciated.”-unknown source
So in other words who knows? Based on this explanation I can be certain it will not help with my monster migraines, where certainly the pain is not reflected in my scalp.
Research suggests it can reduce frequency and intensity:
Two Phase 3 Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials recruited 1384 patients with chronic migraine, and randomised them to treatment with Botox® or placebo. These patients were suffering on average 20 days of headache each month, of which 18 were moderate or severe. Those randomised to Botox® received fixed-site, fixed dose injections every 12 weeks over 56 weeks. These injections covered seven specific areas of the head and neck, with a total dose of between 155-195 units. At six months, after two cycles of treatment, those treated with Botox® had on average eight less days of headache each month. After 12 months, 70% of those treated had ≤50% the number of headaches that they had done originally. Botox® was well-tolerated, the commonest side effects being neck pain (6.7%), muscular weakness (5.5%), and drooping of the eyelid (3.3%). No serious irreversible side effects have ever been reported in trials of Botox® in headache.migraine trust
Anyway, needless to say, I am not in a good mood. At least the Toradol is sitting well with me right now, cause the last thing I need is pain from that. I have one week before I go back to work and I am fine with that as long as I get some slight indication this botox is doing something… anything. Even if it just does a little, we can add to that with other preventatives.