8
SEPT/OCT 2014
Relief for Chronic
Migraines May Come in
the Form of Injections
by Sarah Wilder, Lexington Clinic
Public Relations Specialist
For those who suffer from
chronic migraines, the pain is not
only stressful and inconvenient,
it can be debilitating. The good
news is, there is a treatment option that can reduce the number
of and intensity of migraines
suffered.
Botox brand botulinum toxin
was approved as a treatment
for chronic migraines in 2010.
A trial released earlier that year
demonstrated the positive effect
of botulinum toxin within a large
population of chronic migraine
sufferers. After six months, or
two cycles of treatments, patients
experienced eight fewer migraines per month, on average.
After one year, the study showed
even greater success with the
treatment; 70 percent of patients
regularly treated experienced at
least 50% reduction in migraines.
Since the publication of the
trial, the use of botulinum toxin
for migraine has become a popular topic among physicians who
treat chronic migraines. Although
the specific reasons for why these
injections reduce the occurrences and intensity of chronic
migraines is not currently known,
Eliza E. Robertson, M.D., Ph.D.,
a Lexington Clinic neurologist,
provided some insight into the
matter.
“We know that the toxin
decreases the contraction of the
muscles in which we inject,” Dr.
Robertson said. “However, we
think there may be an additional
effect targeting pain-mediating
neurotransmitters that are associated with migraines.”
This treatment is currently only
recommended for patients who
suffer from chronic migraines, defined with specific criteria, which
includes at least 15 headache
days per month. According to Dr.
Robertson, the data from clinical
trials only applies to this population, and not to those who suffer
from occasional migraines. She
did add, however, that studies
have been promising for chronic
daily headaches.
For patients with chronic
migraines who would like to
explore the option of botulinum
toxin injections as treatment, Dr.
Robertson advises that they first
consult with a physician who currently performs this procedure to
verify their diagnosis of chronic
migraine and that their insurance
will cover the injections.
“Interested patients will not
only need to discuss with their
doctor if these injections are right
for them, they should also verify
with their physician that they
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will receive the FDA-approved
injection site protocol, which is
31 injections in seven muscles
around the head, neck and shoulders,” Dr. Robertson said about
the process. “The protocol can
be modified, if necessary, to each
patient’s needs with subsequent
injections based on tolerability
and symptoms,” she added.
“While Botox, just one of the
three types of botulinum toxin,
funded the trials and obtained
FDA approval for the treatment
of chronic migraines, there are
three forms of botulinum toxin
type A: Botox, Dysport and Xeomin. Within my clinical experience, all three brands of the toxin
work equally well in the treatment of chronic migraine.”
Regardless of which form of
botulinum toxin is used, Dr.
Robertson recommends the
injections as a treatment option
to chronic migraine patients
because the positive effects of the
treatment greatly outweigh the
costs.
“The potential benefits of
this type of treatment include a
reduced number of migraines,
increased hours of productivity,
huge savings in cost, ER visits,
Eliza E. Robertson, M.D., Ph.D.,
Lexington Clinic neurologist
and the avoidance of side effects
from previously or too frequently
used migraine medications. Given the potential overall improvement in well-being and quality of
life, botulinum toxin for chronic
migraine is often the best option
available,” Dr. Roberston said.
“Besides, the procedure goes
relatively fast and, for most, is
well tolerated.”
Please call 859.258.4DOC
(4362) or visit LexingtonClinic.
com