There has been a lot of media attention recently regarding the use of Botox injections for the treatment of chronic migraine.
Several years ago, prior to Botox being licensed as a treatment for chronic migraine, I was invited as one of 12 migraine specialists to a presentation outlining the clinical evidence for the use of Botox injections in this way.
A couple of the consultants present were already using the procedure (off-licence) and not surprisingly were fairly convinced of its efficacy. Several others, including myself at this time, felt further more robust evidence and longer term studies were required.
Nevertheless the licence was subsequently granted and the National Institute for Health and Clinical Excellence (NICE) published its final guidance on Botox for chronic migraine in adults on 27 June 2012, recommending Botox injections “as a treatment option for those who experience chronic migraine and have not responded to taking at least three prior preventative medications, and that their condition has been appropriately managed for medication overuse headache.”
It should be pointed out that the treatment is not considered a `cure` and current evidence suggests the procedure usually needs to be repeated every few months to ensure maintained improvement.
Since the procedure currently involves 32-39 injections at various sites over the scalp (although some specialists are experimenting with fewer injections) and improvement is by no means guaranteed, my position is that this should be a `last resort` approach for severe chronic migraine only after all other treatment modalities have been tried and failed.
Botox treatment/injections are not available at Cheyham Lodge Headache and Migraine clinic however private referrals can be arranged to appropriate specialists if required.
N.b. Currently Botox injection procedures for the treatment of chronic migraine are generally not available on the NHS, although this may change over the coming months.