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View all frequently asked questionsA National Migraine Centre factsheet
This factsheet was produced by headache doctors and brings together the latest trusted advice and information on Botox treatment for migraine.
Available as a series of injections, Botox treatment seeks to prevent headaches for those with chronic migraine, with most people affected seeing improvement after treatment.
The National Migraine Centre provides access to expert clinicians who can provide Botox treatment for migraine in the UK. You can find out more and book an appointment here.
Botox is a brand of botulinum toxin. There are other brands, but these have not been proved helpful in any form of migraine or headache.
The toxin comes from a bacterium called clostridium botulinum. The way it is taken from the bacterium and prepared varies between the different manufacturers, so different brands of botulinum toxin may work differently.
Botulinum toxin gets into nerve endings and stops the nerve being able to respond normally to an electrical nerve impulse. So, when facial expression muscles are injected, facial wrinkles are reduced.
It was noticed by chance that people having cosmetic botulinum toxin injections tended to have fewer headaches. Research then went on to prove that Botox could help people with chronic migraine.
Botox is licensed for the treatment of chronic migraine, which is defined as three months or more of at least 15 days of headache a month, of which at least eight days have features of migraine (such as nausea, light or noise sensitivity, pulsating or lateralised pain).
The National Migraine Centre can connect you with expert headache specialists who can help you determine whether or not you might benefit.
It is thought that the botulinum toxin gets into the small nerves that carry pain from the head to the brain, known as C-fibres. This reduces the amount of chemicals released from the nerve ending, reducing migraine and headache.
Botox is given as a series of 31 to 39 tiny (0.1ml) injections under the skin or into the muscles in and around the head or the forehead, above the ears, and into the neck and shoulders.
The injections are repeated every 12 weeks until the patient no longer has chronic migraine, or until it is clear that treatment is not working.
Normally, those patients who benefit will see an improvement after the first or second set of injections. About one in ten people respond to a third set of injections if the first two sets fail.
The goal is not to become completely free of headache or migraine but to improve quality of life, and to convert migraine from a chronic condition to an episodic one.
Roughly:
The biological effect of botulinum toxin on nerves takes several days, or even a few weeks, to work. You should not expect chronic migraine to improve significantly in less than four weeks.
Botox is only suitable for people with chronic migraine. It’s also not suitable for you if you are pregnant or breastfeeding.
You have an increased risk of side effects if you suffer from another neurological disease (such as Bell’s palsy, a neuropathy, or myasthenia gravis) or if you have had cosmetic botulinum toxin injections in the past three months.
Tell your doctor if you:
The injections are slightly prickly or stingy and take about five minutes to complete.
It is possible, though rare, to have an acute allergic response, so you should stay in the clinic for several minutes after the first set of injections.
Fewer than one in ten patients experience one or more of the following side effects:
Less than one person in 100 may experience:
Contact a doctor immediately or visit your accident and emergency department if you have any of the following after Botox treatment:
Most people have no, or relatively minor, side effects. This is not a full list of side effects and you should discuss with a headache specialist before proceeding.
At the National Migraine Centre, we can provide you with quick and easy access to a clinician who is able to discuss with you Botox treatment.
You can find out more about Botox pricing here or go ahead and request an appointment here.
Listen to our Heads Up podcast episode 4 in series 2 for more information on Botox for migraine.
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