Treatment of migraine with botulinum toxin (commonly marketed as Botox) has been the subject of a series of clinical studies worldwide. Its use has been an established procedure in the USA for some years and is increasing in popularity in the UK as well. Botulinum toxin Type A is a natural protein which blocks the release of acetylcholine. Nerve impulses cannot be transmitted to the muscle, rendering it unable to contract and effectively paralysing it.
The effect of botulinum toxin Type A lasts about two to four months after which time acetylcholine is released again and the muscle in question is reactivated.
There are a number of points at which nerves pass through muscles in the head. When the muscles are contracted, the nerve is compressed. Migraine symptoms in many patients are caused by muscles contracting in the following areas:
An injection of botulinum toxin Type A (Botox) relaxes the relevant muscles. The doctor determines the individual injection sites based on the patient’s trigger points. The patient then documents symptom changes in a migraine diary.
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