An updated guideline from the American Academy of Neurology says that botox, which has long been used to smooth wrinkles on skin and keep people looking young, can also be used as an effective and safe treatment for chronic migraine and other neurological disorders.
Also known as botulinum toxin, which is produced by the Clostridium botulinum and related species of bacteria, the neurotoxic protein prevents substances from being released at nerve endings, which reduces muscle contraction and transmission of pain signals.
The updated guideline, the first since 2008 and was published in Neurology on April 18, was based on a review of scientific studies on botulinum toxin as treatment for chronic migraine as well as for spasticity in adults, which is characterized by muscle tightness that interferes with movement; cervical dystonia, which causes involuntary tilting of the head or neck; and blepharospasm, which causes the eyes to close uncontrollably.
Chronic migraine, which affects more than 37 million people in the U.S., is marked by debilitating headaches marked by intense throbbing or pulsating sensation for at least 15 days in a month.
Guideline author David Simpson, from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues, found that the treatment is safe and effective for these four neurological conditions.
In 2008, the last time the guideline was updated, there was not enough information that would support recommendation of botox for chronic migraine. By 2010, the Food and Drug Administration (FDA) green-lighted the use of treatment for the condition.
"To treat chronic migraines, Botox is given approximately every 12 weeks as multiple injections around the head and neck to try to dull future headache symptoms. Botox has not been shown to work for the treatment of migraine headaches that occur 14 days or less per month, or for other forms of headache," the FDA said.
The newly released guideline now hinges on strong evidence that show botulinum toxin offers benefit albeit small for patients with chronic migraines. Simpson said that botulinum toxin is linked to 15 percent reduction in headaches in a month compared with placebo.
"Headache: OnaBoNT-A is established as effective and should be offered to increase headache-free days (Level A) and is probably effective and should be considered to improve health-related quality of life (Level B) in chronic migraine," Simpson and colleagues wrote.
