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If you know someone who experiences migraines, or get them yourself, you know how debilitating they can be.

An ongoing migraine can mean hours or days spent in bed, with little option but to ride out the pain. We still don’t know exactly how migraines are caused, but there are some triggers.

Certain foods (like cheese and chocolate), alcohol, lack of sleep and stress can all bring on an attack.

Botox injections into the muscles around the head and neck are growing in popularity as a treatment for migraines, but do they work? The rationale is that these muscles are involved in the head pain and make it worse.

In a review of the evidence so far, French researchers were looking for trials that compared a botox treatment for migraine with a placebo injection. They found 17 trials with more than 3000 patients.

Some of the studies looked at what are called chronic migraine, which is where a person experiences at least 15 headache attacks a month for three months. Other studies also looked at episodic migraine, which is where the migraines occur less frequently.

The main outcome the researchers measured was the change in the frequency of migraine attacks after botox, i.e. whether, and by how much they reduced over the following three months.

What they found was that when it comes to chronic migraine, botox had a small significant effect.  It meant, on average, 1.6 fewer attacks in a month.

Its benefit for episodic migraine wasn’t as clear, though there did seem to be a trend towards reducing migraine.

Those in the botox group also reported an improved quality of life in the three months after treatment. There were some mild side effects in the botox group, though – things like double vision, drooping eyelids, and neck pain.

Implications

There aren’t too many treatment options for migraine, so this is good news about botox. That said, the effect is quite small.

The authors say that the study shows botox is safe for people with migraine and can be recommended to them, but it would be useful to see more analysis of how botox compares to existing migraine drugs.

Last Reviewed: 15/02/2020

© Norman Swan Medical Communications.



References

For reference: Bruloy, et al. (2019). Botulinum Toxin versus Placebo: A Meta-Analysis of Prophylactic Treatment for Migraine. Plastic and Reconstructive Surgery doi: 10.1097/PRS.0000000000005111.