Evaluation of botulinum toxin type(A) as a treatment modality for migraine

Botulinum toxin, recognized as one of the most potent biological toxins identified, is a neurotoxin synthesized by the bacterium Clostridium  botulinum. C. botulinum produces eight antigenically distinct exotoxins (A, B, C 1 , C 2 , D, E, F and G).  The aim of this study was to Understand how botulinum toxin works to prevent or alleviate migraine symptoms, Evaluate the possible complications associated with this modality and investigate the efficacy of botulinum in those with chronic or episodic migraines.

Material and Methods: A total of 15 patients (10 males and 5 females) were examined, all of them had a chronic headache and any type of migraine, at the Department of Oral and Maxillofacial surgery/Collage of Dentistry, Al-Farahidi university between February to June 2024. The study received approval from the Faculty of Dentistry administration. Each patient signed Informed Consent, also The patient will be provided with detailed information about Botox injections, including potential side effects, expected outcomes, and the importance of compliance with follow-up visits. Botulinum toxin injections ought to be administered in close proximity to the designated markings in order to prevent the inadvertent tattooing of the skin at the injection site, while simultaneously instructing patients to execute specific facial expressions. locating the superior orbital rim, and avoid giving the toxin below or near the supraorbital foramina pinching the glabellar region to fully catch the muscle, penetrating the whole muscle thickness in order to get fine results providing the toxin into the procerus muscle, frontalis, orbicularis oculi, Temporalis Muscle.

Results: It shows that 15 subjects participated in this study with 10 males (66.7%) and 5 females (33.3%) aged 25-44 years old with mean ±Standard deviation 33.67±5.97, and it shows that 5 subjects (33.33%) with cluster headache while 10 subjects (66.67%) with Migraine, it shows that 10 cases (66.67%) take 100 unit of botulin while 5 cases (33.33%) take 50 units.

Conclusion: BoNT/A was found to be effective and safe in the prophylactic treatment of chronic migraine. BoNT/A is an effective treatment that could be administered by experienced neurologists to eligible CM patients regardless of previous prophylactic treatment.