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Botulinum Toxin for Migraine

  • Maria Eduarda Nobre
  • Marcelo Cedrinho Ciciarelli
  • Jano Alves SouzaEmail author
Living reference work entry

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Part of the Clinical Approaches and Procedures in Cosmetic Dermatology book series (CAPCD)

Abstract

The use of onabotulinumtoxinA in headaches starts in 1997 with exploratory studies for migraine and other headache subtypes. At the same time, laboratory research explored the nonmotor effects of onabotulinumtoxinA.

However, the efficacy was demonstrated just for chronic migraine (CM) and the use was approved in 2010 based on two studies, PREEMPT 1 and 2. These studies consisted of a 24-week randomized, double-blind, placebo-controlled phase followed by a 32-week onabotulinumtoxinA open-label phase. Study injections were given at 31 fixed and 8 optional sites with 5U in each site (total 155U to 195U, mean 165U) across seven head and neck muscle areas (procerus, corrugator, frontalis, temporalis, occipitalis, cervical paraspinal, and trapezius), each 12 weeks.

OnabotulinumtoxinA has shown a safe and effective prophylactic treatment option for patients with CM. Accurate target muscle localization and injection angles and depths are required to achieve optimal outcomes and to minimize adverse events.

Keywords

Headache Chronic migraine OnabotulinumtoxinA 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maria Eduarda Nobre
    • 1
  • Marcelo Cedrinho Ciciarelli
    • 2
  • Jano Alves Souza
    • 3
    Email author
  1. 1.Neurological Clinic Maria Eduarda NobreRio de JaneiroBrazil
  2. 2.Faculdade de Medicina Barão de MauáRibeirão Preto, São PauloBrazil
  3. 3.Universidade Federal FluminenseNiteróiBrazil

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