Botox jabs used to ease migraine misery

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Botox jabs used to ease migraine misery

By JENNY HOPE, Daily Mail

10:04am 31st December 2004

Injections of the pure botulinum toxin have become increasingly popular in

recent years among men and women wanting to smooth out their wrinkles.

But now the medical profession believes that - rather than being restricted

to cosmetic surgery - Botox could help ease the debilitating headaches which

regularly attack migraine sufferers.

Botox works by temporarily paralysing the muscles. Surgeons in the U.S. say

it can be used to pinpoint those muscles which trigger migraines - which are

then surgically removed.

Injections of Botox have already been used to alleviate migraine pain. Its

benefits in this area were discovered after women having injections for

cosmetic reasons reported that their headaches had also eased.

But the new approach takes the treatment a stage further by using a surgical

procedure.

In a trial of 100 patients in the U.S., one in three claimed the operation

cured their migraine attacks.

And half reported an improvement up to a year afterwards, according to the

Plastic and Reconstructive Surgery journal.

The study concluded: " Surgical deactivation of migraine trigger sites can

eliminate or significantly reduce migraine symptoms. "

'Start living their lives again'

Patients received up to three injections of Botox into common headache

" trigger " points, each a month apart. If an injection eliminated or

shortened the frequency of migraine attacks, the patient was then offered

surgery.

Small sections of muscles or nerves were removed by keyhole surgery in the

forehead or back of the head, depending on where the problem originated.

The plastic surgeons claim to have successfully reduced the frequency,

intensity or duration of migraines for 92 per cent of the patients studied.

Dr Bahman Guyuron, clinical professor of plastic surgery at Case Western

Reserve University, Cleveland, said: " Before surgery, my patients expressed

extreme frustration by not being able to gain control of their lives.

" They wanted to work or spend time with their family. Through our new

surgical discoveries we are able to help the appropriate patients escape the

awful effects of migraines and start living their lives again. "

But he admitted it is too early to tell whether the new therapy eliminates

the cause of the attacks permanently.

" A sufficient number of patients should be followed for a meaningful period

of time before the term " cure " can be used for those who become

symptom-free, " he said.

There were side-effects, including eyelid droop, temple hollowing and neck

weakness.

Long-term effects

Dr Anne MacGregor, director of the City of London Migraine Clinic, said

British doctors have not been convinced of the effectiveness of using Botox

alone.

She added: " We must look at the evidence for using it in combination with

surgery and what the long-term effects might be.

" But we should be aware that migraine is a self-limiting condition, it wears

off in many patients after the age of 50.

" Although it is threatening to patients' quality of life, it's important to

remember migraine is not life-threatening and it seems a major step to

surgically remove muscles which, after all, tend to have a purpose. "

Migraines affect around 12 per cent of the UK population - an estimated four

million sufferers - with women the most susceptible.

An attack can last between four and 72 hours. Botox already appears to help

ease a number of other conditions. A recent study suggested it combats back

pain, while there have been promising results from trials on children with

cerebral palsy, aimed at relaxing muscles to help them walk.

People with facial ticks, squints, writer's cramp and involuntary spasms of

the head and neck have also benefited.