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Background Info:
Prior to this study, Botox had been used in clinical practice to treat several disorders believed to be due to overactive striated or smooth muscles. Positive results had also been reported in using Botox to inhibit overactive nonmotor as well as motor peripheral acetylcholine neurons. Not only was it effective in reducing muscle hyperactivity and spasm, Botox treatment often reduce the pain associated with cervical dystonia, achalasia, and rectal fissures. In addition, there was preliminary evidence that it could be effective in the treatment of chronic low back pain associated with muscle spasm. There had also been a noncontrolled study of Botox used as a migraine preventive. This study by Silberstein, et al, was performed to confirm the findings of the uncontrolled study, "by examining the safety and efficacy of BTX-A in the prevention of migraine, using a double-blind, vehicle-controlled design."

Design and Methods of the Study:
"This was a double-blind, vehicle-controlled study of 123 subjects with a history of two to eight moderate-to-severe migraine attacks per month, with or without aura. Participants were randomized to receive single administrations of vehicle or botulinum toxin type A, 25 U or 75 U, injected into multiple sites of pericranial muscles at the same visit.

During a 1-month baseline period and for 3 months following injection, subjects kept daily diaries in which they recorded migraine frequency, migraine severity, and the occurrence of migraine-associated symptoms."

Results:
Compared with subjects who received placebo injections, the subjects in the Botox treatment group experienced:
• Significantly fewer migraine attacks per month
• Reduced severity of migraine attacks
• Fewer days using abortive/rescue medications
• Fewer episodes of vomiting

Conclusions:
"Pericranial injection of botulinum toxin type A, 25 U, was found to be a safe treatment that significantly reduced migraine frequency, migraine severity, acute medication usage, and associated vomiting."

Summary:
Obviously, no therapy will work for all migraineurs, but this study definitely gives hope that Botox injections are helpful as a preventive for a significant percentage of migraineurs. A word of caution - if you are considering Botox injections, please be sure that the doctor administering the treatment is experienced in its use. It's your health. Don't hesitate to ask how many times the doctor has administered Botox and the rate of success achieved.

Based on the information from this study, if you haven't found the right medication or combination of medications to keep your migraine attacks down to a manageable number, you may want to consider giving them a bit of food poisoning.

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