August 3, 2021:

Keisuke Ueda, MD

Pediatric Neurology

Washington University School of Medicine

“Botox injections should be considered to be an alternative treatment option for the migraine in children”. Keisuke Ueda, MD

What is Botox?

Botox is a drug made from a neurotoxin by Clostridium botulinum. It is the same toxin that causes botulism, a life-threatening food poisoning. When botulinum toxin is purified and used in small doses in specific areas, it temporarily inhibits neurotransmitters from transmitting pain signals to the brain.

 

Botox for headache

In 2010, Botulinum toxin A (Botox) was approved for use with chronic migraines and has been used for the treatment of adults with migraines. Recently, clinical studies of children and adolescents with chronic intractable migraines have reported success and shown that Botox injections would provide relief from a headache by reducing the frequency and severity of headaches.

 

Procedure

The procedure takes about 5 minutes to cover the whole head. It can cause pain or bruise, but no patient has suffered serious side effects or discontinued the treatment due to side effects. There are no restrictions after the treatment and no risk of drug interactions.

 

After the treatment.

It usually takes time for Botox to be effective. It usually takes a week to see some benefit, reaches its peak around 1 month, then gradually wears off. Typically, one treatment lasts for 10-12 weeks. To have continuous benefit, the treatment is usually repeated every 3-4 months. Some people do not see any benefit from the first injection. I still recommend at least 3 trials as a cumulative effect has been seen frequently.

 

The intractable migraine can be very disabling and impacting the quality of life negatively, causing many medication uses, absences from school and ER visits. The Botox injections should be considered to be an alternative treatment option for the migraine in children.