Botox Injections.

Chronic migraines are extremely disabling and can significantly affect quality of life. They affect 1.6% of adults and are defined as headaches occurring on more than 15 days a month. Currently there is no cure for chronic migraine and the condition could be managed by life style changes, avoiding triggers and medications. Preventative medications over long periods of time can cause side effects in many patients. A neurologist referral might often be necessary to diagnose chronic migraine and exclude potential sinister pathologies.

NICE has recommended Botox type A for prophylaxis of adult patients suffering with chronic migraine:

• whose headaches have not responded to taking at least 3 prior migraine preventative medications

• whose condition has been appropriately managed for medication overuse

Botox is thought to work by changing pain neurotransmitter release and impulse transmission in small nerves. It is administered in the outpatient clinic and patients need several injections into the muscles using tiny needles. NICE recommends that the injection is repeated every 12 weeks for suitable patients.

Two randomised control trials involving 1384 patients showed that at 6 months, after two cycles of treatment, patients had on average 8 less days of headaches every month. After 12 months 70% of those treated had <50% the number of headaches that they had originally. Common side effects reported are neck pain (7%), muscle weakness (5%) and drooping of eye lid (3%).

Botox Injections are offered by Dr Prabhu Gandhimani, Consultant and Pain Specialist, Appointments can be made on: 0208 949 9020

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