Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-22T01:35:07.624Z Has data issue: false hasContentIssue false

Chapter 31 - The Use of Botulinum Toxin in the Management of Headache Disorders

Published online by Cambridge University Press:  02 November 2023

By
Hsiangkuo Yuan  and
Stephen D. Silberstein
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
Get access

Summary

Migraine is a primary headache disorder characterized by enhanced sensitivity of the nervous system associated with a combination of neurological, gastrointestinal and autonomic disturbances (Silberstein, 2004). Chronic headache is a heterogeneous group of headache disorders that include chronic migraine (CM), chronic TTH (CTTH) and other headache types that occur 15 days or more per month (for a minimum of 3 months).

OnatotulinumtoxinA (onabotA) therapy has been used for a variety of disorders associated with painful muscle spasms. It is generally believed that, following intramuscular injection, onabotA produces partial chemical denervation resulting in a reduction in muscle activity and a broader inhibition of peripheral and central pain sensitization. OnabotA therapy is FDA-approved for use in patients with chronic migraine. This chapter discusses the definition of chronic migraine, patient selection for treatment with onabotA, and presents the PREEMPT injection protocol for the application of onabotA, with clinical description and pictural illustration of the injection site.

Keywords

Headachemigrainetrigeminovascular systembotulinum neurotoxinBoNTBoNT-AonabotulinumtoxinAonabotAPREEMPT
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 252 - 259
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aurora, SK, Dodick, DW, Diener, HC et al. (2014). OnabotulinumtoxinA for chronic migraine: efficacy, safety, and tolerability in patients who received all five treatment cycles in the PREEMPT clinical program. Acta Neurol Scand, 129, 61–70.Google Scholar
Aurora, SK, Dodick, DW, Turkel, CC et al., PCMS Group (2010). OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia, 30, 793–803.CrossRefGoogle Scholar
Aurora, SK, Winner, P, Freeman, MC et al. (2011). OnabotulinumtoxinA for treatment of chronic migraine: pooled analyses of the 56-week PREEMPT clinical program. Headache, 51, 1358–73.CrossRefGoogle ScholarPubMed
Blumenfeld, AM, Silberstein, SD, Dodick, DW et al. (2017). Insights into the functional anatomy behind the PREEMPT injection paradigm: guidance on achieving optimal outcomes. Headache, 57, 766–77.CrossRefGoogle ScholarPubMed
Diener, HC, Dodick, DW, Aurora, SK et al., PCMS Group (2010). OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia, 30, 804–14.Google Scholar
Dodick, DW, Silberstein, SD, Lipton, RB et al. (2019). Early onset of effect of onabotulinumtoxinA for chronic migraine treatment: analysis of PREEMPT data. Cephalalgia, 39, 945–56.Google Scholar
Dodick, DW, Turkel, CC, DeGryse, RE et al., PCMS Group (2010). OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache, 50, 921–-36.CrossRefGoogle ScholarPubMed
Frampton, JE (2020). OnabotulinumtoxinA in chronic migraine: a profile of its use. CNS Drugs, 34, 1287–98.CrossRefGoogle Scholar
Freund, B, Rao, A (2019). Efficacy of botulinum toxin in tension-type headaches: a systematic review of the literature. Pain Pract, 19, 541–51.CrossRefGoogle ScholarPubMed
GBD 2019 Diseases and Injuries Collaborators (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396, 1204–22.Google Scholar
Headache Classification Committee of the International Headache Society (IHS) (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38, 1–211.CrossRefGoogle Scholar
Herd, CP, Tomlinson, CL, Rick, C et al. (2019). Cochrane systematic review and meta-analysis of botulinum toxin for the prevention of migraine. BMJ Open, 9, e027953.CrossRefGoogle ScholarPubMed
Ishii, R, Schwedt, TJ, Dumkrieger, G et al. (2021). Chronic versus episodic migraine: the 15-day threshold does not adequately reflect substantial differences in disability across the full spectrum of headache frequency. Headache, 61, 992–1003.CrossRefGoogle Scholar
Lipton, RB, Varon, SF, Grosberg, B et al. (2011). OnabotulinumtoxinA improves quality of life and reduces impact of chronic migraine. Neurology, 77, 1465–72.CrossRefGoogle ScholarPubMed
Matharu, M, Halker, R, Pozo-Rosich, P et al. (2017). The impact of onabotulinumtoxinA on severe headache days: PREEMPT 56-week pooled analysis. J Headache Pain, 18, 78.CrossRefGoogle ScholarPubMed
Silberstein, SD (2004). Migraine. Lancet, 363, 381–91.CrossRefGoogle ScholarPubMed
Silberstein, SD, Blumenfeld, AM, Cady, RK et al. (2013). OnabotulinumtoxinA for treatment of chronic migraine: PREEMPT 24-week pooled subgroup analysis of patients who had acute headache medication overuse at baseline. J Neurol Sci, 331, 48–56.CrossRefGoogle ScholarPubMed
Silberstein, SD, Dodick, DW, Aurora, SK et al. (2015). Per cent of patients with chronic migraine who responded per onabotulinumtoxinA treatment cycle: PREEMPT. J Neurol Neurosurg Psychiatry, 86, 996–1001.CrossRefGoogle ScholarPubMed
Simpson, DM, Hallett, M, Ashman, EJ et al. (2016). Practice guideline update summary: botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 86, 1818–26.CrossRefGoogle Scholar
Yuan, H, Silberstein, SD (2021). The use of botulinum toxin in the management of headache disorders. In Whitcup, SM, Hallett, M (eds.) Botulinum Toxin Therapy. Cham: Springer, pp. 227–49.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×