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Chapter 31 - The Use of Botulinum Toxin in the Management of Headache Disorders

Published online by Cambridge University Press:  02 November 2023

By
Hsiangkuo Yuan  and
Stephen D. Silberstein
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Migraine is a primary headache disorder characterized by enhanced sensitivity of the nervous system associated with a combination of neurological, gastrointestinal and autonomic disturbances (Silberstein, 2004). Chronic headache is a heterogeneous group of headache disorders that include chronic migraine (CM), chronic TTH (CTTH) and other headache types that occur 15 days or more per month (for a minimum of 3 months).

OnatotulinumtoxinA (onabotA) therapy has been used for a variety of disorders associated with painful muscle spasms. It is generally believed that, following intramuscular injection, onabotA produces partial chemical denervation resulting in a reduction in muscle activity and a broader inhibition of peripheral and central pain sensitization. OnabotA therapy is FDA-approved for use in patients with chronic migraine. This chapter discusses the definition of chronic migraine, patient selection for treatment with onabotA, and presents the PREEMPT injection protocol for the application of onabotA, with clinical description and pictural illustration of the injection site.

Keywords

Headachemigrainetrigeminovascular systembotulinum neurotoxinBoNTBoNT-AonabotulinumtoxinAonabotAPREEMPT
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 252 - 259
Publisher: Cambridge University Press
Print publication year: 2023

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References

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