What type of headaches do I have? The first step
in headache management is to determine the nature of your
headaches: Migraine, Tension, Cluster or other type.
An appointment with one of our
physicians at the American Migraine Center will be
arranged. See contact information.
Is there a reason I suffer from headaches? An
examination and additional tests (if necessary) will be
utilized to rule out any organic source for your headaches.
Can my headaches be treated with medication? Many
migraine headaches can be controlled with conventional
medicines. Your medicines will be reviewed and optimized in
an initial attempt to eradicate your headaches.
What if my headaches do not respond to medication?
If medication fails to provide relief, Botox® injections
may be an option for the treatment for your headaches.
What is Botox® and what does it do? Botox® is a
small dose of Botulinum toxin that is injected into the
forehead, temples or back of the head. Botulinum toxin
temporarily paralyzes muscles. When given into the forehead,
frown lines will flatten. Patients generally look younger.
How does Botox® improve headaches? Although the
exact mechanism is not known, relief of pressure on nerves
and breaking the spasm/pain cycle are possible mechanisms.
This is an off-label use of Botox®.
How long does Botox® last? Muscle paralysis
following an injection of Botox® may last from 3 to 6
months. Your migraine headache, however, may improve for
only 1 to 3 months.
Into which areas of my head will the injections be
given? One or more small injections will be given into
the area around your trigger points. The trigger points are
often on the left and right sides of your forehead, temple
and back of the head.
Do Botox injections work immediately? The
injection takes 2 to 7 days to reach maximum effect. Rarely,
the effect may not be apparent for up to a month. The effect
will be assessed after 30 days with a post injection
questionnaire and a physical examination.
What do I do after the injections? We would like
you to keep a daily log of the frequency and intensity of
your headaches. You should continue all your usual daily
medicines until your follow-up in a month. You may use
abortive migraine medications (triptans) for severe
headaches.
What are the most common side effects of Botox®
injections? Inability to frown and a youthful look are
tradeoffs that are considered an advantage by most people.
Botox® injections rarely have side effects. Transient
stinging at the injection site, bruising and some swelling
may be noted for a few days after the injection. A cold
compress may be used to relieve the pain and swelling.
Temporary drooping of the upper eyelids and temporary
hollowing of the temples may occur. Because the effects of
Botox® only last for a few months, any untoward events are
transient as well.
If Botox® improves my headaches, what does this mean?
Our recent studies indicate that 80% of patients experienced
elimination or significant improvement of their migraine
headaches following Botox® injection. The effect is
temporary, however. A good response to Botox® with
headache relief or significant improvement, indicates that
you are likely to benefit from surgery. Surgery provides
longer lasting results and a consultation with Dr. Guyuron
or Dr. Michelow at the Zeeba Clinic, will be arranged. Learn more about surgical
treatment methods.
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