May 16 2008
Migraines and Botox
Part of the benefits of blogging that I have come to enjoy is the added chance to get to know whatever subjects there is out there. Through blogging, I have come to learn a lot of things, from the trivial, to the more general subjects. Yup, learning that is unconfined to the bounds of the 4 walls of the classroom.
Uhmmm..come to think of it, its been ages (and I mean ages) since I have stepped within the familiar walls of a classroom. So in a way, it has taken a bit of an adjustment on my part, but one which I have welcomed with open arms. ![]()
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Anyway, back to the subject at hand: Botox. What is it and what is it for?
Before writing this post, I am pretty sure I have heard it before, but like the average person, I guess it didn’t quite strike my curiosity before, which explains why I have never exerted effort to learn whatever it is.
So, for the benefit of the average person (including me) out there, let me share with you what I have learned.
Botox (botulinum toxin) is a purified protein that belongs to a class of compounds known as neurotoxins. It was first approved by the FDA for the eye muscle disorders strabismus and belpharospasm in 1989 and has been used in other conditions where muscle hyperactivity is an underlying problem. The mechanism of action of Botox has been thought to be weakening or paralysis (depending on dose) of muscles by preventing the release of acetycholine, a signal that the nerves need to cause muscle contraction. This is the same substance which is produced in spoiled food and causes the illness known as botulism. However, in medical use, the Botox is injected directly into the muscles involved rather than absorbed into the bloodstream, and the doses used are much less than those which cause botulism. Because Botox is a neurotoxin, there are concerns about its safety. However, it has had a remarkable good record since its introduction in 1989. Because it is injected into muscle and not absorbed into the system, side effects that occur frequently with other migraine preventives, such as drowsiness, dizziness, weight gain, and mental changes, are not seen with Botox. Some mild pain at the injection site for a day or two is about the only side effect our patients notice. Drooping of the eyelid is a common side effect but can usually be avoided by proper injection technique, and when it occurs, lasts only a few days.
So there you have it. However, I did more research, regarding the use of this on the treatment of migraines, and here’s what I found. The question the next paragraph aims to answer is the question on the use of Botox for migraines:
“Why does it work on migraines?”
Based on the mechanism of action of Botox, it is unlikely that anyone would have thought to try it for migraines. Its success in treating some patients has caused problems for those who would attempt to explain why it would work in migraine. One possibility is that muscle tension may act as a trigger for migraine in the same way that light and odors do. By reducing muscle tension, Botox would be eliminating an irritant to the nervous system, which would then reduce the chances of a migraine developing. More recently, studies have shown that Botox may affect other nerve cell signallng systems that have to do with the perception of pain. In an animal model of pain, injection of Botox under the skin resulted in decreased response to painful stimuli. Traditionally, scientists have thought that the pain of migraine was due to swelling and inflammation of blood vessels, but perhaps muscle tension is more of a factor than previously appreciated.
Equally important in considering the beneficial effects of Botox, one should also consider other concerns, such as safety issues. Currently, Botox is not approved by the FDA for headache treatment. The decision to use Botox should be based on a discussion with your physician. Failure to respond to standard migraine preventives or side effects from them should be an important consideration. Since the effect of Botox lasts about 3 months, one can weigh the costs of the injections versus the amount that would be spent on headache treatment during that time.
I do hope this little research of mine has given you an insight on this particular subject, I hope you have learned something useful. I know I have.
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