Botox as a Chronic Migraine Treatment

What treats eye spasms, muscle contractures, hyperhidrosis, and most recently, chronic migraines? The answer comes from the 1950’s discovery where scientists found botulinum toxin (BOTOX®) to reduce muscle spasms in the human body.

According to a study done by Allergan, the manufacturer of BOTOX®, the injectable medication is indicated for the prophylaxis of headaches in adult patients with chronic migraines. On June 24th, 2013, a 60-second television advertisement debuted promoting BOTOX® as a treatment for the chronic migraine condition.

What is a Chronic Migraine?

A chronic migraine is defined as someone suffering more than 15 days per month with headache lasting 4 hours a day or longer. By this definition, people living with chronic migraines are spending half their month living with debilitating headaches.

In a study of 520 chronic migraine patients, 80% were properly diagnosed. Here’s a real story from a lady named Emily who’s had debilitating headaches, from chronic migraines, for years:

When Emily’s headaches started years ago, she first noticed flashes of light in the left eye. After a few minutes, the flashes stopped and an intense headache started, followed by general discomfort, uneasiness, and vomiting. The headache pain was usually pulsating, located on 1 side of her head.

In the past 5 years, the headaches have increased in frequency to approximately 18 to 20 per month. Emily is talking to her doctor about treatment options. (Source:

Acute Migraine Treatment

Currently there is no cure for chronic migraines, but there are treatments to help manage this debilitating condition. Most treatment options fall into two groups: acute and preventative.

Acute treatment of the migraine is geared to prevent the progression of the headache as soon as it starts. Here are some general principles of acute migraine care:

  • Treat the headache as early as possible in the attack to reduce the intensity and duration of the attack as well as the accompanying features. Failure to use this effective therapy can result in increased pain, disability, and impact of the headache.
  • Tailor your treatment to both the individual and the individual attack.
  • Use the correct dose and formulation. The route of administration is important in patients experiencing severe nausea and vomiting.
  • The use of acute therapy should be limited to a maximum of 2 to 3 days per week and should not rely on narcotics to avoid rebound.

 Preventative Migraine Treatment

Preventative treatments are usually medications prescribed to prevent headaches before they start. These treatment options are taken on a regular basis with the goal being to reduce the frequency and severity of attacks. Here are some general principles of preventative migraine care: 

  • Start the chosen drug at a low dose and increase it slowly until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or adverse events become intolerable.
  • Give each treatment an adequate trial. The full benefit of the drug may not be realized until six months have elapsed.
  • Set realistic goals. Success is considered to be a 50% reduction in attack frequency, or a significant decrease in attack intensity or duration.
  • Avoid acute headache medication overuse and drugs that are contraindicated because of coexistent or comorbid illnesses.

Dr. Verebelyi’s BOTOX® Treatment

Colorado Skin and Vein is known for using only the best injectable products available on the market. Our team can help treat your chronic migraine pain, but it’s important to understand the limitations of this treatment option, first.

Although the vast majority of our patients see significant improvement from this treatment, the effectiveness of for episodic migraines (less than 14 headaches a month) has not been established in formal studies.

Dr. Verebelyi along with Colorado Skin and Vein is one of the top providers of Botox in Denver, Colorado. If you’re suffering from chronic migraines and/or are interested in learning more about the treatment benefits of BOTOX®, please contact us and we’d be happy to discuss your needs.

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