BOTOX® and Migraine in the UK


In May 2012, the National Institute for Health and Clinical Excellence (NICE) who licence new treatments for the NHS has given the green light for migraine treatment with BOTOX®. This treatment is offered to patients who suffer from chronic migraine and for whom previously prescribed medication have not been successful.

The NICE approach

The BOTOX® procedure approved by NICE is known as the Preempt Protocol and involves BOTOX® being administered in 31+ sites over the head and neck. This concept follows the pain – BOTOX® is used as a pain reliever.

Challenges of the Preempt Protocol

This approach however does not allow the neurologist to find the precise trigger points, the area where the migraine attacks begin, so once BOTOX® needs to be re-administered it is very unlikely to be injected into the same sites as before. Accordingly, this approach cannot guarantee a consistent treatment.

Implications for patients

Therefore the BOTOX® administered by neurologists does not give the patient the relief anticipated and is proving to be ineffective and disappointing for many, who should be getting very good relief from the correct administration. As a direct result, the NHS will withdraw BOTOX® from a patient if there is no significant improvement after 3 treatment cycles.

Strong treatment criteria

The conditions that NICE and NHS have attached to the provision of the BOTOX® Preempt Protocol will make it very difficult for most migraine sufferers to be treated, as local PCTs will need to provide funding. Patients will need to fit strong criteria to gain access to the BOTOX® treatment.

The msc approach

At the msc Migraine-Surgery-Centres in London and Manchester, BOTOX® has already been used for many years to treat migraine patients. Since 2005, the concept has proved to be very effective for people who are not responding to pharmaceutical products developed for the treatment of migraine. Our Doctors have spent many years researching the most effective way to use BOTOX® to treat migraine. The discovery of four key areas to administer BOTOX® represents a far more effective way to treat patients.

Comprehensive questionnaire

At msc a comprehensive patient questionnaire gives our Doctors all the information required to treat our patients in a unique way. Our approach is to administer BOTOX® in up to three different sites to relax very small muscles either in the neck or forehead which have nerves running through or very close to them. BOTOX® stops the constant irritation of these nerves by switching these tiny muscles off. In approximately 50% of patients this approach gives immense relief from migraine by reducing the pain and frequency of migraine episodes.

Pioneering surgery procedure as BOTOX® replacement

At msc we have developed a further procedure bought about by the successful results of our BOTOX® treatment. We have pioneered an outpatient surgical procedure which can provide a permanent solution by removing or dissecting the muscles away from the nerves, which have been identified by successful BOTOX® test as trigger points, giving a permanent solution and no longer requiring BOTOX® or other migraine medication.

Predictable surgery results

Surgery will only be considered if the changes in the migraine symptoms are unambiguous during our eight week BOTOX® test where a daily migraine diary must be provided. If there is more than a 50% improvement you will be invited for a further consultation to discuss further treatment.

Further Information

NHS news "Botox gets nod for migraine"