Abstract
The use of botulinum toxin for movement disorders and cosmesis led to an accidental discovery of its beneficial effect on headaches. Extensive anecdotal evidence and several controlled trials suggest that intermittent and chronic migraines and chronic tension headaches may respond to this treatment. The effect of a single treatment, which is simple to administer, can last for 3 months. Botulinum toxin does not cause systemic or any other serious side effects. Prophylactic pharmacotherapy of migraine headaches is limited in its efficacy and has a potential for systemic side effects. This makes botulinum toxin a preferred treatment for many patients. The large controlled trials that are underway may lead to a wider acceptance of this treatment by neurologists and pain specialists.
Similar content being viewed by others
References and Recommended Reading
Erbguth FJ, Naumann M: Historical aspects of botulinum toxin. Justinus Kerner (1786-1862) and the "sausage poison". Neurology 1999, 53:1850–1853.
Sloop RR, Cole BA, Escutin RO: Human response to botulinum toxin injection: type B compared with type A. Neurology 1997, 49:189–194.
J. Jankovic J, Schwartz K: Botulinum toxin injections for cervical dystonia. Neurology 1990, 40:277–280.
Foster L, Clapp L, Erickson M, Jabbari B: Botulinum toxin A and chronic low back pain: a randomized, double-blind study. Neurology 2001, 56:1290–1293.An excellent trial that confirmed the efficacy of Botox in the treatment of chronic low back pain.
Binder WJ, Brin MF, Blitzer A, et al.: Botulinum toxin type A (BOTOX) for treatment of migraine headaches: an openlabel study. Otolaryngol Head Neck Surg 2000, 123(6):669–676.
Giladi N: The mechanism of action of botulinum toxin type A in focal dystonia is most probably through its dual effect on efferent (motor) and afferent pathways at the injected site. J Neurol Sci 1997, 152(2):132–135.
Aoki R: The development of BOTOX: its history and pharmacology. Pain Digest 1998, 8:337–341.An excellent review of the pharmacology of botulinum toxin.
Göbel H, Heinze A, Heinze-Kuhn K, Austermann K: Botulinum toxin A in the treatment of headache syndromes and pericranial pain syndromes. Pain 2001, 91:195–199.A comprehensive review of the use of botulinum toxin in headaches and pericranial pain by an eminent clinician-scientist, who is a major proponent of this treatment.
Smuts JA, Barnard PWA: Botulinum toxin type A in the treatment of headache syndromes: a clinical report of 79 patients. Cephalalgia 2000, 20:332.
Mauskop A, Basdeo R: Botulinum toxin A is an effect prophylactic therapy of migraines. Cephalalgia 2000, 20:422.
Brin MF, Swope DM, O’Brian C, et al.: Botox for migraine: double-bind, placebo-controlled region-specific evaluation. Cephalalgia 2000, 20:421–422.
Krack P, Hornig C, Dorndorf W: Resolution of chronic tension headache after botulinum toxin treatment of idiopathic blepharospasm. Mov Disord 1995, 10:388.
Göbel H, Lindner V, Krack P, et al.: Treatment of chronic tension-type headache with botulinum toxin. Cephalalgia 1999, 19:455.
Schulte-Mattler WJ, Wieser T, Zierz S: Treatment of tensiontype headache with botulinum toxin: a pilot study. Eur J Med Res 1999, 4(5):183–186.
Relja MA: Treatment of tension-type headache with botulinum toxin: 1-year follow-up. Cephalalgia 2000, 20:336.
Rollnik JD, Tanneberger O, Schubert M, et al.: Treatment of tension-type headache with botulinum toxin type A: a double-blind, placebo-controlled study. Headache 2000, 40(4):300–305.
Freund BJ, Schwartz M: Treatment of whiplash associated neck pain with botulinum toxin-A: report of 8 cases. J Rheumatol 1999, 26(3):756–758.
Freund BJ, Schwartz M: Treatment of chronic cervicalassociated headache with botulinum toxin A: a pilot study. Headache 2000b, 40(3):231–236.
Hobson DE, Gladish DF: Botulinum toxin injection for cervicogenic headache. Headache 1997, 37(4):253–255.
Klapper JA, Mathew NT, Klapper A, Kailasam J: Botulinum toxin type A (BTX-A) for the prophylaxis of chronic daily headache. Cephalalgia 2000, 20:291–292.
Freund B, Schwartz M: The use of botulinum toxin A in the treatment of refractory cluster headache: case reports. Cephalalgia 2000a, 20:329–330.
Ginies PR, Fraimout JL, Kong A, et al.: Treatment of clusterheadache by subcutaneous injection of botulinum toxin. 8th World Congress on Pain, 1996. Poster presentation: 50.
Silberstein S, Mathew N, Saper J, et al.: Botulinum toxin type A as a migraine preventive treatment. Headache 2000, 40:445–450.The first large, double-blind trial that showed the efficacy of Botox in the prevention of migraines.
Blumenfeld AM: Impact of botulinum toxin type-A treatment on medication costs and usage in difficult-to-treat chronic headaches: case studies. Headache Quart 2001, 12:241–244.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mauskop, A. The use of botulinum toxin in the treatment of headaches. Current Science Inc 6, 320–323 (2002). https://doi.org/10.1007/s11916-002-0054-1
Issue Date:
DOI: https://doi.org/10.1007/s11916-002-0054-1