Botulinum Toxin

  • Thomas Muehlberger


The use of botulinum toxin as a treatment for migraine has an inconsistent and lingering history. Following years of rejection, the PREEMPT trials eventually found that it is useful as a prophylactic for chronic migraines. The surgical and neurological approaches employing botulinum, however, are fundamentally different. Furthermore, the surgical use is based on its peripheral mechanism, a localized muscle paralysis, whereas the neurological use is based on alleged central mechanisms and directly antinociceptive properties. The botulinum-induced deactivation of trigger sites can simulate the surgical procedure and should be used as a preoperative test. There is no standardized method to determine the individual selection of trigger sites; the approach presented herewith is a recommendation. Botulinum toxin is a safe and effective agent with rare, mild, and transient side effects.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Thomas Muehlberger
    • 1
  1. 1.Medsteps AGChamSwitzerland

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