When to Consider Botox Injections for Migraine

Almost everyone gets a headache at some time or other, and probably one that’s interfered with their day. Did you know that there are over 150 different kinds of headaches, some mild and some that can pose a serious threat to your health? Headaches are so prevalent that, according to the World Health Organization, tension-type headaches (TTHs) and migraine are two of the most common medical conditions worldwide.

At Memphis Neurology, our expert team of neurologists diagnoses and treats patients with migraine disease at our offices in Germantown, Tennessee, and Southaven, Mississippi. One of our primary migraine preventive therapies is Botox®, a neurotoxin that can calm the nerve signals that trigger a migraine attack. Here’s when you should consider this treatment option.

Primary vs. secondary headaches

Headaches are divided into two big categories: primary and secondary. Primary headaches are disorders unto themselves; they don’t result from any underlying condition or disease. Secondary headaches are painful episodes caused by another disorder or condition, such as getting a headache when you have a cold or the flu.

Primary headaches are further broken down by type, and the three most common types are TTHs, migraine, and cluster headache.

What is migraine?

Migraine isn’t just a bad headache; it’s a neurological disorder that, along with crippling pain, causes neurological symptoms. Some of the most common are sensory disturbances, loss of mental focus, and severe nausea and vomiting. Attacks can last between 4-72 hours. That makes migraine, according to the Migraine Research Foundation, the sixth-most disabling disease in the world.

Unlike with TTHs that feel like your whole head is in a vise, migraine pain usually presents on just one side of the head. People often describe it as throbbing, and it worsens with any kind of movement. Neurological symptoms include an increased sensitivity to light, sound, and odors; GI distress; and trouble concentrating, among others.

A migraine attack is divided into four discrete phases, though you can get just one phase, a combination of two or three, or all of them during an attack. They are:

1. Prodrome

This initial phase starts up to 24 hours before the pain hits and is characterized by an assortment of symptoms that includes uncontrollable yawning, shifting moods, food cravings, trouble concentrating, and a vague sense that “something is wrong.”

2. Aura

Most people with migraine experience attacks with an aura or without an aura, but rarely both. If an aura manifests, it starts about 20-30 minutes before the pain hits and can be characterized by visual disturbances like seeing stars, flashing lights, or zig-zag lines; muscle weakness; and garbled speech.

3. Pain

Interestingly, not everyone with migraine experiences the pain, even though this is the phase that most people think of when they hear “migraine.” The pain may start gradually or come on suddenly, and it grows more severe with throbbing or pulsing on one side of your head until you feel like your head’s going to split open.

Along with the pain comes a whole host of neurological symptoms, including light, noise, and odor sensitivity; nausea and vomiting; constipation, and “brain fog.”

4. Postdrome

Once the pain passes, you enter the final phase, which is like a post-adrenaline crash. You may continue to feel weak, confused, and out of sorts for another day or two.

When to consider Botox injections for migraine

Migraine requires different types of medications than TTHs; some are designed to prevent attacks and some to abort ones in progress. Some pharmaceutical options for abortive therapy include the triptans, the ergotamines, and the new gepants like Nurtec ODT®.

Preventive therapy is equally important, and leading the charge at the moment are the revolutionary new anti-CGRP monoclonal antibodies, specifically tailored for migraine and prohibitively expensive if you don’t have insurance.

A tried-and-true preventive for chronic migraine (15 or more migraine days a month) is Botox. Medically called onabotulinumtoxinA, it’s made from the same bacterium that causes food poisoning. However, when diluted and administered by an expertly trained physician, this FDA-approved migraine treatment works by temporarily paralyzing the nerve fibers responsible for the pain phase, blocking the signals from reaching the brain. The preventive effects can last 3-4 months, at which time you can repeat the treatment.

If migraine is interfering with your ability to live your life normally, it’s time to come into Memphis Neurology to find out if Botox is right for you. To get started, give us a call at either of our locations, or book a consultation online.