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Botulinum toxin for Chronic Migraine

What is the definition of chronic migraine ?

Typically, if an individual has greater than 15 migraine headaches a month, then they are given the diagnosis of chronic migraine.  Usually these individuals have suffered from migraines since childhood or teenage years.

How does Botulinum toxin work to relieve symptoms of chronic migraine?

Botulinum toxin is one of the most powerful toxins in the world.  It acts by paralyzing the muscles. It is believed that by relieving the tension in the muscles of the head and neck, symptoms of migraines are relieved.  This is a preventative treatment for chronic migraine.

Is the botulinum toxin same as the one used for wrinkles?


How is the botulinum toxin administered for chronic migraines?

Typically, a total of 155 units of botulinum toxin (type A) are used.  Botox is the most common commercially available botulinum toxin.  A total of 31 shots, consisting of 5 units each are given at various sites including the forehead, multiple sites in the side and back of the head, neck and shoulder muscles.

How long do the effects last?

The effects last 3 months. Botulinum toxin injections are given every 3 months.

Are there any side effects?

Potential side effects include eyelid drooping, neck muscle weakness.  These are rare.  Similar to be beneficial effects, the side effects also go away in 3 months.

How efficacious is this for chronic migraines?

I have had a 60-70% success rate.  Most of the patient have a greater than 50% reduction in headache frequency and intensity.

Is this covered by insurance?

We usually get authorization from the insurance companies.  Depending on the plan, they may have co-pay.  






Shanker Dixit MD, FAAN Dr. Dixit is a board certified neurologist practicing in Las Vegas, Nevada. He has over 25 years of experience treatment of neurological conditions. He has also done extensive research and has several scientific publications to his name. He did his neurology residency at the University of Wisconsin , Madison Wisconsin. He was elected as a Fellow of the American Academy of neurology, a prestigious honor, in 2017

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