Botox® is licensed for the treatment of chronic migraine, defined as 3 months of at least 15 days of headache a month, of which at least 8 days have migrainous features, such as nausea, light or noise sensitivity, pulsating or lateralised pain.
Botox ® is given as a series of 31 to 39 tiny (0.1 ml) injections under the skin or into the muscles in and around the head of 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 a response is seen after the first or second set of injections; only about one in ten people respond to a third set of injections if the first two sets fail.
In a study of adults who get chronic migraine headaches, treatment with Botox® 47% of patients had a 50% or greater reduction in the number of days with headache. They also had more "crystal-clear" pain free days each month with fewer days off work.
About a quarter of patients do not respond; a quarter respond well to the first or second set of injections, and half need more than two sets of injections to get a good response.
Botox® is like a block in that pathway. It stops the chemicals transmitting pain signals before they get to the nerve endings (of the C-fibres) around your head and neck.
The goal is not to become completely free of headache or migraine; but to improve quality of life, and to convert migraine from chronic to episodic.
The effect of botulinum toxin on nerves takes several days or a few weeks to work. You should not expect chronic migraine to improve properly in less than 4 weeks. Some patients do not start to improve until after their second set of injections which is given 12 weeks after the first set of injections.
A full consultation and a discussion with your GP is required before commencing injections for management of chronic migraines.
All treatments offered for chronic migraines are provided by Amy, an experienced dentist, fully qualified in Botox® injectables since 2012, in a CQC-inspected dental clinic in Wetherby, Yorkshire.
Amy Robbins, a gentle female dentist in Wetherby can treat migraine, headaches with splints + botox