Botox for Chronic Migraine

Abstract

Chronic migraine is a debilitating neurological disorder with a significant impact on patients\' quality of life. This study aimed to evaluate the clinical efficacy and safety of botulinum toxin type A (onabotulinumtoxinA) as a preventive treatment for chronic migraine in a real-world clinical setting. Forty-eight patients diagnosed with chronic migraine received two treatment cycles of botulinum toxin according to the PREEMPT protocol. After 6 months, the average number of monthly headache days decreased by over 50%, with notable reductions in pain intensity, acute medication use, and migraine-related disability scores (MIDAS). The treatment was well-tolerated, with only minor and self-limiting side effects. These findings confirm that Botox is an effective and safe option for reducing the burden of chronic migraine and improving quality of life in affected individuals.

Introduction

Chronic migraine, a disabling neurological condition, affects 1–2% of the global population and often resists traditional oral preventive treatments. Botulinum toxin type A (Botox) has emerged as an effective alternative, particularly after the PREEMPT clinical trials. It works by blocking pain-mediating neuropeptides, reducing headache frequency and severity through neuromodulation.

This study evaluated the effectiveness and safety of Botox in 48 chronic migraine patients over six months. Following two treatment cycles using the standard 31-injection protocol, patients experienced a significant reduction in monthly headache days (from 21.4 to 10.6), headache intensity (VAS score from 7.3 to 4.2), and acute medication use (by 40.2%). Disability, measured by MIDAS scores, also improved substantially (from 42.5 to 21.3). Botox was well-tolerated, with only minor, self-resolving side effects like neck stiffness or injection site pain in a few patients.

The findings affirm Botox's role as a safe, well-tolerated, and effective preventive therapy for chronic migraine, especially in treatment-resistant cases. While results align with previous clinical trials, limitations include the small sample size, single-centre design, short follow-up period, and absence of a control group. Nonetheless, the study supports Botox as a valuable long-term treatment strategy and encourages further research on its sustained effects and optimisation in clinical practice.

Conclusion

Chronic migraine is a debilitating neurological disorder characterised by headache occurring on 15 or more days per month, of which at least 8 days involve migraine features, lasting for more than three months. It affects approximately 1–2% of the global population and significantly impairs daily functioning, social participation, and quality of life. Despite the availability of various oral preventive medications, many patients remain refractory to traditional therapies due to limited efficacy, adverse effects, or poor tolerability [1, 3].

References

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Copyright

Copyright © 2025 Khasanov Alisher Yurevich, Khaydarov Shokhrukh Khaydarovich, Madasheva Anajan Gazkhanovna. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.