Headache Pain
Botulinum toxin can be and is used for headache. “Let me emphasize it is off label, at least for now. I would describe it as very controversial,” Dr. Ward said. “There is good evidence that it does not work for tension-type headache.” Conflicting evidence exists regarding other headache types. It may be effective in chronic migraine if the patients are not on preventive treatments. “There is an [American Academy of Neurology] assessment that basically outlines what it thinks are the flaws in the evidence—that it doesn’t work for tension-type headache, that maybe it works in some cases in some types of migraine—and I would recommend that you read that because it is evidence based.”
—Glenn S. Williams
Suggested Reading
Dodick DW, Turkel CC, Degryse RE, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010 May 17; [Epub ahead of print].
Naumann M, So Y, Argoff CE, et al. Assessment: Botulinum neurotoxin in the treatment of autonomic disorders and pain (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70(19):1707-1709.
Simpson DM, Blitzer A, Brashear A, et al. Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70(19):1699-1706.
Simpson DM, Gracies JM, Graham HK, et al. Assessment: Botulinum neurotoxin in the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008;70(19):1691-1698.