scholarly journals The use of Botulinum toxin type A for the treatment of refractory chronic migraine

2021 ◽  
Author(s):  
Gabrielle Torres Oliveira Lemos ◽  
Gabriel das Chagas Benevenuto ◽  
Gabriela Guy Duarte ◽  
Bruno Alves Pinto ◽  
Ivan Magalhães Viana
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Botulinum Toxin Type A ◽  
Clinical Excellence ◽  
Type A ◽  
Infiltration Rate ◽  
Botulinum Toxin Type ◽  
Control Group ◽  
Pubmed Database ◽  
Refractory Chronic Migraine

Background: Chronic migraine is a neurological disorder described as refractory to preventive treatments. Based on the PREEMPT study, the National Institute for Health and Clinical Excellence (NICE) and the FDA approved, in 2010, the use of Botulinum Toxin type A (BoNT/A) to treat refractory chronic migraine. Objectives: To review the effectiveness of the use of BoNT/A in the treatment of refractory migraine. Methods: Bibliographic review based on PubMed database, using the descriptors “migraine” and “botulinum toxin”. Clinical trials, meta-analyzes and randomized controlled tests, from the last five years, were defined as inclusion criteria. Results: Sanz et al., (2016) infiltrated BoNT/A in 69 patients - mean age 43 years old, 88.4% women, mean infiltration rate was 2,0. The reduction of headache days and pain intensity was 48.5% and 20.5%, respectively, both statistically significant (p <0.006). Ion et al., (2018) intervened 61 patients - mean age 50 years old, 87% women, mean infiltration of 3.5. 73% showed a reduction greater than 50% for the frequency of migraine episodes, 48% for headache days and 48% for drug use. Dodick et al., (2019) applied BoNT/A in 688 patients - 696 received placebo. The severity and frequency of pain showed a statistically significant reduction (p < 0.001) after the first week of treatment in relation to the control group. Conclusions: The use of BoNT/A to treat refractory chronic migraine proves to be effective, although there is need for studies with larger samples to ensure its effectiveness.

Chronic migraine and Botulinum Toxin Type A: Where do paths cross?

Toxicon ◽  
2020 ◽  
Vol 178 ◽  
pp. 69-76
Author(s):  
Daniele Martinelli ◽  
Sebastiano Arceri ◽  
Livio Tronconi ◽  
Cristina Tassorelli
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Botulinum Toxin Type A for Lumbar Sympathetic Ganglion Block in Complex Regional Pain Syndrome: A Randomized Trial

2021 ◽  
Author(s):  
Yongjae Yoo ◽  
Chang-Soon Lee ◽  
Jungsoo Kim ◽  
Dongwon Jo ◽  
Jee Youn Moon
Keyword(s):  
Botulinum Toxin ◽  
Complex Regional Pain Syndrome ◽  
Sympathetic Ganglion ◽  
Botulinum Toxin Type A ◽  
Pain Syndrome ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Control Group ◽  
Ganglion Block ◽  
Relative Temperature

Background The present study was designed to test the hypothesis that botulinum toxin would prolong the duration of a lumbar sympathetic block measured through a sustained increase in skin temperature. The authors performed a randomized, double-blind, controlled trial to investigate the clinical outcome of botulinum toxin type A for lumbar sympathetic ganglion block in patients with complex regional pain syndrome. Methods Lumbar sympathetic ganglion block was conducted in patients with lower-extremity complex regional pain syndrome using 75 IU of botulinum toxin type A (botulinum toxin group) and local anesthetic (control group). The primary outcome was the change in the relative temperature difference on the blocked sole compared with the contralateral sole at 1 postoperative month. The secondary outcomes were the 3-month changes in relative temperature differences, as well as the pain intensity changes. Results A total of 48 participants (N = 24/group) were randomly assigned. The change in relative temperature increase was higher in the botulinum toxin group than in the control group (1.0°C ± 1.3 vs. 0.1°C ± 0.8, respectively; difference: 0.9°C [95% CI, 0.3 to 1.5]; P = 0.006), which was maintained at 3 months (1.1°C ± 0.8 vs. –0.2°C ± 1.2, respectively; P = 0.009). Moreover, pain intensity was greatly reduced in the botulinum toxin group compared with the control group at 1 month (–2.2 ± 1.0 vs. –1.0 ± 1.6, respectively; P = 0.003) and 3 months (–2.0 ± 1.0 vs. –0.6 ± 1.6, respectively; P = 0.003). There were no severe adverse events pertinent to botulinum toxin injection. Conclusions In patients with complex regional pain syndrome, lumbar sympathetic ganglion block using botulinum toxin type A increased the temperature of the affected foot for 3 months and also reduced the pain. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Botulinum Toxin Type A in the Treatment of Chronic Migraine Without Medication Overuse

2007 ◽  
Vol 0 (0) ◽  
pp. 071203213825001-??? ◽  
Author(s):  
Frederick G. Freitag ◽  
Seymour Diamond ◽  
Merle Diamond ◽  
George Urban
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Botulinum toxin type A for cephalic cutaneous allodynia in chronic migraine: a randomized, double-blinded, placebo-controlled trial

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Luciano Hollanda ◽  
Larissa Monteiro ◽  
Ailton Melo
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Controlled Trial ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Efficacy Analysis ◽  
Scale Scores ◽  
Efficacy Measures ◽  
Double Blinded

Cephalic allodynia (CA) can be observed in 50-70% of patients with chronic migraine (CM). The aim of this trial was to assess the efficacy of botulinum toxin type A (Botx-A) in the treatment of CA associated with CM. In this placebo-controlled trial, patients were randomized either into Botx-A or 0.9% saline injections and efficacy measures were assessed every 4 weeks for 3 months. Efficacy endpoints were number of migraine episodes associated with CA, changes from baseline in visual analogical scale scores for pain (VAS) and frequency of common analgesics use for migraine. A total of 38 subjects were randomized to saline (n=18) or Botx-A (n=20). There were no significant differences in baseline between active intervention or placebo groups regarding mean age, number of headache episodes [mean 12.1 (9.22) and 17.00 (9.69) respectively; P=0.12], pain severity as measured by the VAS or frequency of analgesic use for headache episodes. Efficacy analysis showed that Botx-A injections led to an important decrease from baseline in the mean migraine episodes associated with CA after 12 weeks (5.20 versus 11.17; P=0.01). Also, VAS scores and frequency of analgesics use for headache were significantly reduced in the Botx-A group. This study suggests that Botx-A injections are superior to saline in the treatment of CA associated with CM, with mild self limited side effects.

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