scholarly journals Experience of Botulinum Toxin A Injections for Chronic Migraine Headaches in a Pediatric Chronic Pain Clinic

2021 ◽  
Vol 26 (2) ◽  
pp. 151-156
Author(s):  
Lisgelia Santana ◽  
Cherry Liu
Keyword(s):  
Botulinum Toxin ◽  
Chronic Migraine ◽  
Pediatric Patients ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Pain Clinic ◽  
Low Grade ◽  
Pediatric Pain ◽  
Botulinum Type

OBJECTIVES Prevalence of chronic migraine in children can reach 7.7%, causing decreased school performance, difficulty with extracurricular activities (including sports, theater, or music), and changes in sleep and mood. Many studies confirm that botulinum toxin type A injections effectively alleviate chronic migraines in adults; however, the literature regarding children is sparse. This study aims to analyze the safety and effectiveness of botulinum type A injections in a group of pediatric patients diagnosed with chronic migraines in a pediatric pain clinic. METHODS In this retrospective (2013–2018) study, the effects of botulinum toxin type A injections were analyzed using data from 65 pediatric patients diagnosed with chronic migraines. The study group ranged from 11 to 18 years of age. A pediatric pain management physician administered the botulinum using the Phase 3 Research Evaluating Migraine Prophylaxis Therapy program protocol and followed the pain pattern. Dosages, tolerance, and side effects were measured. RESULTS In this study, 74% of the patients tried more than 6 medications before the injections. There was a decrease in the visual analog scale score of 5.2 ± 2.2 points upon 6-week follow-up. The mean amount of medication used was 173.2 ± 35 units, and patients received an average of 2.8 ± 1.1 units/kg. Adverse events include one patient who developed dizziness and another who had low-grade fevers with enlarged cervical lymph nodes; both resolved within few minutes. CONCLUSIONS This study supports the use of botulinum type A for chronic migraines in pediatric patients. Multicentered, randomized studies with larger population are needed to evaluate the long-term safety and efficacy of this therapy.

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

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.

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.

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