Botox®, or botulinum toxin, was licensed for the treatment of chronic migraine in 2010 in the UK by the Medicines and Healthcare products Regulatory Agency or MHRA. Then in 2012, the NHS announced it would offer Botox for the prevention of migraines after guidance published by the National Institute for Health and Clinical Excellence (NICE).
NICE recommended that Botox could be used as a migraine therapy for patients that had experienced headaches for at least 15 days of every month and which, on at least eight of those days, had the features of a migraine. The patient also had to have not responded to at least three preventative drug treatments.
Botox is a neurotoxin protein that is produced by the bacterium Clostridium botulinum. In the 1970s and 80s, a preparation of botulinum toxin type A was used to treat blepharospasm and squints. Although now known around the world as a wrinkle-blasting treatment, it is also used to treat a wide range of medical conditions, including dystonia, hyperhidrosis and post-stroke spasticity and juvenile cerebral palsy.
During the 1990s, patients undergoing Botox for aesthetic purposes started to report an improvement in their headaches. A number of clinical trials into the treatment of various types of headaches followed, but results didn’t suggest a significant improvement in most types, but it seemed that it could help to alleviate chronic migraine.
Botulinum toxin can reduce pain in certain medical conditions by relaxing overactive muscles, but it is not completely clear why it works for migraine relief. One theory is that it relaxes muscles around the head, reducing blood pressure within the brain. Or it might reduce the expression of certain pain pathways involving our nerve cells.
Before publishing its guidelines on the use of Botox for treatment of migraine, NICE looked at all the trials that compared botulinum toxin type A with a placebo. In two large-scale trials, Botox injections reduced the frequency of headaches and helped to improve quality of life.
If you are interested in learning more about the use of Botox for the treatment of migraines, Youth Doctors offers the only Botox course for migraine relief in the UK and Europe. Call 0790 0583 898 to find out more information about our courses.
