by Nesreen Suwan, M.D.
The best day for headache sufferers was when a new treatment option became available. In July 2010, U.K. drug regulators became the first in the world to approve wrinkle treatment Botox as a way to prevent migraines. BOTOX - has been licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) as a preventive headache treatment following great success with clinical trials.
In clinical trials, patients were given BOTOX injections into specific head and neck muscles every 12 weeks. After 24 weeks, those treated with Botox had fewer days with a migraine than those who received the placebo treatment.
By one year, nearly 70% of those treated with Botox had a 50% reduction in the number of migraines compared with before the trial. The final results were published in reputable HEADACHE medical journal in May this year.
Injections of Botox are commonly associated with smoothing out and easing pain of wrinkles. It has been reported to be the most common aesthetic medical procedure. The discovery of BOTOX for treatment of headaches was related to reporting improvement of chronic headache with cosmetic BOTOX injection.
However, migraine authorities made it clear that the treatment should only be administered only by specialized professionals, not those who typically use it for cosmetic purposes. This is related to the fact that migraine is a neurological disorder, and there are many challenges in recognizing, diagnosing and treating migraine. As such, they are supposed to be evaluated and treated by specialized professionals.
Migraine is a common debilitating genetic neurological disorder that affects approximately 30 million Americans. Unfortunately, the impact of migraine is greatest between the ages of 20-50, which are the most productive years where family and professional demands are at their peak. Migraine is considered the leading cause of disability in the world, when measured by days missed from work.
Migraine has always been an under-researched, under-diagnosed and under-treated condition by both patients and physicians. This may be related to the fact that most headache patients may be initially seen in non neurological clinics and may end up with an inaccurate diagnosis of sinus or tension headaches. Leave alone the fact that many patients may receive a diagnosis of tension or sinus headaches by family members or coworkers if not self diagnosed. This would lead to ineffectual treatment modalities. Diagnosis could be a significant challenge for non specialists. Migraines, although under diagnosed, should not be over diagnosed as well overlooking other causes of headaches. Considering the fact that migraine symptoms may be shared by other types of headaches and many types of headaches may coexist in the same patient, migraine diagnosis and treatment should be performed by a specialized experienced neurologist.
Non specific acute pain medication may not be a good choice and may create rebound headaches added to the endless side effects that are associated with chronic use. Abortive migraine specific medications like TRIPTANS are always a better choice; however, they should be used under the care of a specialist. There are plenty to choose from based on the present and past medical history of each patient. Abortive medications may be used alone or combined with preventive medications
The above noted modalities do not work with all patients and new therapies for this potentially disabling condition, are always welcome. Migraine sufferers may stay in bed and some will go to the hospital if the attack is severe. It has always been a dream of chronic migraine sufferers to get more headache-free days to be able to make more plans and not be so debilitated by their chronic migraines missing golden moments with family and friends. The dream came true a long time ago for Cindy Doman, a long life migraine sufferer who has been treated successfully in our clinic with BOTOX for prevention of chronic migraines.
"You have no idea what migraine sufferers have been missing out on" said Cindy who has been very excited knowing about this step forward in chronic migraine management.
As a neurologist and headache specialist, I have been using BOTOX injection for over 15 years for many neurological conditions, including chronic headache management for over 10 years.
Although in the UK, the first approval of BOTOX for the treatment of chronic migraines early this July is extremely significant for me as a neurologist and headache specialist who used BOTOX off label for chronic migraine suffers with great success for over 10 years.
Although Botox has been used off label for chronic migraines in US, a growing number of insurance companies have been covering the costs of Botox injections. The reasonable cost of Botox injections versus the huge cost of other daily headache treatments coupled with disability, and work loss caused by debilitating migraines, made BOTOX a great choice.
With this exciting breakthrough news about the effectiveness of BOTOX injection in managing chronic migraines, there is no reason to suffer of debilitating migraines, or to cope with endless side effects of daily medications.
It is a huge step forward and new day for all chronic headache sufferers who have the right to enjoy more crystal clear headache free days. As Botox had been easing the cosmetic pain of wrinkles, now it is the time to ease the pain and burden of chronic migraines.
Dr Nesreen Suwan, is Loyola trained American Board certified Neurologist. She is board certified in Electrodiagnostic Medicine, and Pain Medicine, with extra certification in Headache medicine, and BOTOX treatment. Dr Suwan specializes in treatment of headaches, migraines and fibromyalgia. She is Director of Advanced Chicago Headache and Fibromyalgia Center in Suburban Lisle at 2867 Ogden. Dr. Suwan is highly recognized as a headache specialist and she is nationally known speaker in her field.