Botox and Migraine

February 2007 - Recent research by Dr Jeffrey Janis, assistant professor of plastic surgery at the University of Texas Southwestern Medical Center and Dr Bahman Guyuron, a plastic surgeon at Case Western Reserve University has contributed to a pioneering surgical technique that can significantly reduce the frequency and intensity of migraine headaches in patients in whom other treatments have failed.

Building on earlier research published in Plastic & Reconstructive Surgery, the report cites data from the National Institutes of Health indicating that approximately 28 million Americans (75 per cent women) suffer from migraines resulting in an estimated 157 million lost workdays annually.

Jeffrey Janis explained:

"The technique includes using the anti-wrinkle drug Botox to pinpoint which of several specific muscles in the forehead, back of the head or temple areas may be serving as 'trigger points' to compress, irritate or entrap nerves that could be causing the migraine. Because Botox temporarily paralyzes muscles, usually for about three months, it can be used as a 'litmus test' or 'marker' to see if headaches go away or become less intense. If the Botox is successful in preventing migraines or lessening their severity, then surgery to remove the targeted muscle is likely to accomplish the same result, but on a more long-term and possibly permanent basis"

Sharon Schafer Bennett began suffering migraines as a teenager, the headaches becoming increasingly frequent and unpredictable. Her quality of life was impaired to the point that she was unable to work or participate in her children's daily activities. Treatment five years ago has resulted in a reduction in headaches from several each week to one every few months.

Sharon Schafer Bennett commented:

"I can't even begin to tell you what a change this has made in my life. For the first time in years, I can live like a normal human being and do all the normal 'mom' and 'wife' things that the migraines physically prevented me from doing. My family thinks it's great because they don't have to put their lives on hold numerous times a week because of my migraines. I'm also going back to school to get a second degree, something I could never have considered before."

Jeffrey Janis said:

"Many neurologists are using Botox to treat migraines, but they are making the injections in a 'headband-like' circle around the forehead, temple and skull. They are not looking at finding the specific location of the headache's trigger point. While patients may get temporary relief, after the Botox wears off they will have to go back and get more injections or continue medications for migraines.

"It's like a math equation. I will inject the Botox into one trigger point at a time and leave the others alone. The Botox is used as a diagnostic test to determine what trigger point is causing the problem. If patients get a benefit from the Botox, they likely will get a benefit from the surgery. If there's no benefit from the Botox, then there won't be a benefit from the surgery."

Jeffrey Janis added:

"Plastic surgeons are not in the business of diagnosing and treating headaches. This is a novel method of treatment that is proving to be effective and potentially more long lasting than other things used before. But it is still in its infancy."