Most people are unaware that the use of Botox for the prevention
of migraine headaches came about purely by accident. It all
happened through the use of Botox by plastic surgeons. Patients
undergoing plastic surgery, who were also experiencing
headaches, noticed that their injections of Botox helped with
their migraine headaches.
Botox, also known as botulinum toxin, is a neurotoxin (a toxin
that attacks nerve cells). It was originally approved by the FDA
for use in conditions where hyperactivity of muscles was an
underlying problem of related health and medical conditions. The
theory is that Botox weakens or paralyzes muscles by inhibiting
the release of acetylcholine. Acetylcholine is an ester of
choline that is thought to play an important role in the
transmission of nerve impulses at synapses and myoneural
(muscle-nerve) junctions. By inhibiting the release of
acetylcholine the nerves cannot cause a muscle contraction, thus
relaxing the muscle. Botox is administered by being directly
injected into the affected muscles.
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There are differing theories as to how Botox works to eliminate
migraineheadaches, but the exact reasoning remains unclear. One
theory is that muscle tension and spasms are a cause of
migraines and by eliminating the muscle tension with an
injection of Botox it will also eliminate the cause of the
headaches. If given Botox before the headache begins it is
possible to eliminate the headache before it even starts.
When muscles spasm it can irritate nerves that innervate them.
When these nerves send signals to the brain in an increased
amount it causes pain and possibly headaches. Botox may affect
these nerve cells, inhibiting their transmission, causing a
lessening of the perception of pain. Many researches think that
migraine headaches are a result of inflammation of blood
vessels. However, muscle tension may also play an important role
in the cause of headaches.
When researchers test a medication's effectiveness they usually
test it through a double-blind study. This means that some
patients are given the medication being tested while others are
given a placebo. A placebo is an inactive substance, such as
sugar, that is given in place of the medication that is being
evaluated. Some tests have been performed that did not involve
double-blind studies, but showed that Botox could prevent
migraine headaches. One double-blind study involving Botox and
headaches showed only a small positive effect.
Initial studies may not have shown the full effectiveness of
Botox for the prevention of headaches. The injections were not
placed in the typical locations of the headache pain, but in
areas normally injected during plastic surgery. In subsequent
studies, using larger doses and injecting into more specific
localities for the headache pain, the results were improved.
These tests were concerning migraine headaches. However, with
tension headaches, or muscle tension headaches, the studies have
shown improved results. This is to be expected due to the
weakening or paralyzing nature of Botox on the muscles that are
experiencing tension.
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When being injected with Botox for the prevention of headaches
it may take several weeks before the injection takes effect. For
this reason it is usually necessary to have it injected no more
often than once every 3 months or so. People that have Botox
administered for the treatment of headaches typically need it
injected every few months. If there is too long of an interval
between injections the headaches may be experienced by the
patient.
However, the question arises about the safety of these regular
injections of a neurotoxin. Since 1989, when it was first used
as a headache treatment, it has appeared to be fairly safe. Most
migraine headache medications are taken orally and eventually
end up in the blood stream. Because of this common symptoms of
migraine headache medication will be dizziness and drowsiness
among other symptoms. Since Botox is injected directly into the
muscle tissue and does not get absorbed into the blood system as
does the typical headache medicine there are fewer side effects.
Most commonly, the only side effects of injecting this
neurotoxin is pain in the area of injection for a couple of days
or drooping of the eyelids for a few days.
Studies are still being performed on this medication and as yet
the FDA has not approved it for the treatment of headaches.
However, physicians do prescribe it to their patients and if you
think you are a candidate to use it you should discuss it with
your doctor. If you do not respond to other headache medications
it may be something to talk with your physician about. As the
studies continue the effects and safety issues involving this
medication should become more clear.
About the author:
Dr. Larry A. Johnson, D.C. has patented a popular
chiropractor-recommended cushion for the home treatment of
headaches, both tension and migraine. Visit his site about headaches - tension and
migraine for more information. Dorothy Musgrave
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