What Causes Chronic Migraines
Pinpointing the exact causes of migraine headaches can be complicated. Why? A confluence of factors may be to blame.
Researchers believe that genetics and family history make individuals more prone to developing migraine headaches. The weather, specifically a change in barometric pressure, may play a slight role. Unfortunately, theres not a lot you can do to intervene in factors such as these.
But dont lose hope. Many other contributing factors to migraine headaches can be addressed.
According to the American Migraine Foundation, medical conditions such as anxiety, mood disorders, insomnia, jaw disorders, asthma, sleep apnea, and hormonal changes may trigger migraines. Luckily, many of these problems are treatable conditions.
Your lifestyle may also trigger migraines. Adverse lifestyle factors that can contribute to migraines often include:
- Excess stress
- Consuming certain foods or food additives
- Medication overuse
To gain better insight into the causes of your specific migraine headaches, you should consider keeping a headache diary. Journal about when your migraine started, the symptoms, how long it lasted, and what contributing factors may be to blame.
A headache diary can be an invaluable resource for your doctor and/or treatment team to pinpoint the recurrent events that trigger your migraines. Furthermore, your doctors can use this information to develop an effective plan of action to eradicate your migraines.
Frisco Tx & Southlake Tx
The Center for Neurology and Neurophysiology, PA, offers the most innovative solutions for treating acute and chronic migraines. At their clinics in Frisco and Southlake, Texas, the team provides customized treatment plans to help you finally find relief from head pain and its associated symptoms. Whether you need Botox® therapy or can benefit from migraine prevention resources, the headache specialists at The Center for Neurology and Neurophysiology can help. Learn more about available treatment options for migraines by calling the office nearest you or using the convenient online booking feature to schedule an appointment.
Botox Injection for Chronic Migraines Q & A
How Often Do I Get Botox Injections For Migraine
In general, most people start with 2 treatments, 12 weeks apart, and then treatment is continued every 12 weeks. You will receive injections 4 times per year or as directed by your healthcare provider.
Some patients may feel headache results as soon as 4 weeks. Follow your doctors instructions exactly.
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How Does It Work And How Effective Is It
Though there’s still more research to be done on Botox for migraines and doctors aren’t yet completely sure why the procedure is effective, they have some ideas. Ravitz tells me, “What does is paralyze nerve terminals. Essentially, nerve terminals transmit pain, but they also produce pain substances while theyâre doing that, and it completely paralyzes that process.” She says that it stops the process of pain patterning and it also relaxes the muscles.
According to Ravitz, it’s very effective among a large sampling of her patients and is usually very well tolerated. She says some of her patients find that it even eliminates the need for medication, which is a huge deal. However, she also says, “About 7 to 10 percent of my patients find that itâs not effective and they actually feel worse during that time.” As with any medical procedure, everybody is different and will respond to treatment differently, and it’s best to do a healthy amount of research and thoroughly talk to your doctor about your body and medical history before making a decision.
Who Are Appropriate Candidates For Botox Treatment
OnabotulinumtoxinA is the only treatment approved by the United States Food and Drug Administration for the prevention of headaches in adult patients with chronic migraine . CM assessment involves a detailed history to rule out secondary sources of headache, establish migraine features, and assess the total number of headache days. In order to diagnose migraine, the patient should have had at least five attacks that involve migraine features, as outlined below. In adults, untreated attacks usually last 4 or more hours.
A migraine requires only two of the following headache features: a unilateral distribution , pulsatile quality , moderate or severe pain , and aggravation by physical activity . In addition, to diagnose migraine, only one of the following is required: nausea or vomiting or sensitivity to light and noise.
Migraine can be subdivided depending on whether there is an aura or not and also on the frequency of the headaches.
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How Does Botox Work For Chronic Migraines
Botox is the neurotoxin botulinum toxin. The paradigm for the inject delivers Botox into nerve endings at the scalp, neck, and shoulders to both the inflamed coverings of the brain and essential neurological pathways to help stop the chronic migraine process and prevent the onset of a migraine.
Treatment with Botox is typically available if you suffer from chronic migraine pain at least 15 days or more a month. If you develop migraines less frequently, the team can recommend other treatments and preventive options.
Are There Side Effects
According to the FDA approved labeling text under section 17.3 Medication Guide Botox and Botox Cosmetic for injection may cause serious life threatening side effects.Problems or symptoms to watch for after treatment can include: difficulty swallowing, speaking and breathing.The “problems can happenhours to weeks after an injection” and lead to death if complication develops with your breathing muscles becoming too weak to function normally.Even though the FDA says it has no “confirmed serious” cases of the spread of the toxin to other parts of the body when Botox has been used at the recommended dose for treatments, they still make a special note of the symptoms to watch for.
They say that the spread of toxins away from the injection site may create these symptoms: overall body muscle weakness, double or blurred vision, drooping eyelids, loss of voice, trouble speaking, loss of bladder control, trouble breathing and trouble swallowing.And what about food poisoning… isnt that what botulism is? Botox injection for migraine can also cause flu like symptoms as side effects.
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Botox And Chronic Migraine
Many of us think of Botox injections as a way to help conceal the visible signs of ageing. But Botox has its roots in treating a range of medical conditions and is now used as a preventative for chronic migraine.
Botox works to gradually decrease the frequency and severity of migraine headaches, and for many people its an effective treatment that improves their quality of life.
It Can Take Several Months To See Results
If you don’t experience relief from migraine right away, don’t swear off the treatment immediately. Dr. Najib recommends trying two rounds of Botox before making a decision about whether it’s working for you. Even if the treatment ends up helping after the first round, he says results typically take two to four weeks to kick in. There’s no taper required to discontinue the treatment.
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Does Botox Work For All Headaches
There are some headache types that dont respond well to BOTOX treatment. The most notable are those where the pain affects the regions between the eyes, behind the ears, on the top of the head or around the cheeks.
Tension headaches have been shown to respond to BOTOX treatment in some instances, but not all sufferers are so fortunate. The patients who get the best results have headaches that stem from chronic muscle tension or contraction. The reason for this is by partially paralyzing the contracting muscle, the relaxing effect helps prevent the headache occurring.
The types of headache that respond best to BOTOX treatment include:
- Those with vise-like, crushing or squeezing types of pain.
- Headaches caused by muscle spasms originating in the back of the neck.
The areas of the head where BOTOX has the most noticeable effect are typically experienced across the forehead extending to the temples, and down the back of the neck.
How Fast Does The Treatment Work
The relief experienced by BOTOX is not immediate, and most people find they still need rescue medications or some form of additional meds that they normally take for headache reduction.
It generally takes a few days, around three or four in most cases, for the effect of BOTOX to take hold. It can be as long as a week to ten days before the full benefit is realized.
Treatments for tension headaches or migraine normally need to be repeated every three or four months. It’s important to realize that the overall effect is likely to be a reduction in the frequency of headache or migraine episodes, rather than a complete cure.
Going from 15 or more headaches per month down to around seven or eight is common. Some people may find that Botox has no effect on their pain levels or frequency, but for most it means fewer days out of action with pain, and less reliance on other forms of medication. Particularly for tension headaches, BOTOX can be an effective preventive medication.
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What Are Common Side Effects Of Botox
There are very few side effects associated with Botox treatments. The needle used is very small while some people may feel a small pinch with the injection, many dont feel anything.
Other side effects can include some neck pain and muscle weakness where the medication was injected. Using ice packs can help reduce this pain if it happens. Rarely, people can experience eyelid drooping or muscle weakness in areas further away from the injection site.
Studies have shown that up to five treatment cycles of Botox is safe and effective for chronic migraines.
What Can I Expect When I Receive Botox Injections For Migraine
Botox injections to prevent headaches in adults with chronic migraine are generally safe, but they may cause some mild side effects. To learn more, see the Botox side effects section above. You can also refer to the Receiving Botox injections section above and talk with your doctor.
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Who Can Be A Candidate For Botox And Who Wouldnt
Discover more about botox fda here.
But be certain to stick to the dosing schedule your doctor recommends for you. For the use talked about above, the really helpful dose of Botox is one hundred fifty five total units divided into 31 injections. These injections shall be given in seven particular muscle areas in your head and neck. Each muscle area has a variety of sites the place 0.1 milliliters of Botox might be injected.
What To Expect During Botox Treatment
Before your first Botox treatment your neurologist should discuss the side effects and risks. This is a good time to ask questions and check if they follow the established Botox protocol for chronic migraine.
Your neurologist uses a small needle to inject 0.1ml or 5 units of Botox at each site just under your skin. You may feel a slight sting with each injection. Because Botox comes in 100 unit vials some neurologists may do a few more injections around areas where you experience your migraine pain.
The treatment takes about 1520 minutes and there arent any restrictions on driving or other daily activities after treatment.
Its important to remember Botox isnt a quick fix for migraine. It often takes 2 or 3 treatments to notice if its effective in reducing the frequency or intensity of your migraine pain. Botox treatment is repeated every 12 weeks, which means it may take 69 months to notice any difference. Some people have reported improvements after their first treatment, so like many migraine treatments results are very individualised.
Many people report the benefits of Botox start to wear off after about 10 weeks, and the intensity and frequency of their migraine attacks increase close to their next treatment date.
You dont need to stop taking other preventative medications with Botox treatments and you can continue to use abortive medications if you need them.
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How Is Botox Administered
The only way to receive BOTOX treatment is via injections. This can cause some people who might benefit from it to shy away from the treatment. Because the needles and doses are very small, however, its not like receiving a normal shot. Most patients describe the sensation as briefly pricking or stinging, and uncomfortable rather than painful. Since the doses injected are very small, the procedure takes only a few minutes, with the majority of patients well enough to go home or back to work immediately afterwards.
Injections are normally administered in the forehead, the temples, between and/or above the eyebrows, and in the upper neck behind the head.
Rebound Headaches And Botox
Rebound headaches or medication overuse headaches are caused by excessive use of acute medications. Unfortunately they have a low response to prophylactic treatments meaning that preventive medications are not effective when a patient is experiencing rebound headaches. Essentially, to end the rebound headaches cycle, you must stop all pain relievers.
Botox for Migraine has been determined to be beneficial in patients who have rebound headaches. There is some research which suggests to stop all medications first before initiation expensive Botox treatment. Be your own advocate and ask for treatment which will increase your likelihood of success in ending your rebound cycle.
My chronic migraine journey began five years ago when I got pregnant and gave birth to my kids. I developed chronic migraine complicated by rebound headaches. Daily migraine attacks left me home-bound and hopeless. I ended my rebound cycle by taking a Medrol steroid taper, getting nerve blocks, Botox injections, and chiropractic treatment. My headache specialist helped me succeed in ending my rebound cycle by offering these options to me.
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What You Need To Know About Migraine And Botox
Weve all heard of Botox, responsible for generations of smooth foreheads in Hollywood. But Botox has also brought relief to many people who suffer from chronic medical conditions. In 2010, Botox was approved for use with chronic migraine, and many patients are reporting success. What do you need to know before considering it?
How Botox Works For Migraines
Botox works by reducing muscle contractions and stopping neurotransmitters from sending pain signals to your brain. This can help reduce the pain caused by migraines and lets many patients enjoy daily life without interruption.
The effect is only temporary, so patients will need to receive ongoing treatment. The most common treatment timeline involves an injection every 12 weeks, or four times per year. It may take several weeks to experience migraine relief after an injection. Your doctor may adjust this timeline according to your individual needs.
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How Much Does Botox For Migraines Cost
The cost of Botox treatments can vary somewhat, so its important to ask your healthcare provider upfront what you will be charged.
In general, each treatment session will use a total of about 155 units of Botox, and that can cost anywhere between $300 to $600, or even more. Because these treatments can be expensive, you should search for coupons or savings plans that are available to help lower the cost. For example, the manufacturer of Botox, Allergan, offers a savings card and a patient assistance program to help reduce costs or even make it free for patients.
What Side Effects Might I Get
The injections are slightly prickly or stingy and take about 5 minutes to complete.
It is possible, though rare, to have an acute allergic response so you should stay in the clinic for several minutes after the first set of injections.
Less than one in ten patients experience each of the following side effects:-
Worsening migraine. This can begin within a day or two of the injections, usually lasts a small number of days. It can be treated with triptans and/or regular naproxen 250 mg or 375 mg three times daily after meals.
As with all injections pain, bruising, bleeding or infection where the injection was given are a possibility
1. Drooping of eyebrows or eye lids. This begins after a couple or a few weeks and can last for a small number of weeks.
2. Muscle weakness, pain, cramp, stiffness or tightness
3. Weakness and pain in the neck. This begins after a couple or a few weeks and can last for a small number of weeks. It can be treated with regular naproxen as in above.
Less than 1 in 100 may experience:
Difficulty in swallowing
If you have any difficulty in breathing, swallowing or speaking after receiving Botox contact your GP immediately.
If you experience hives, swelling including the face or throat, wheezing, feeling faint and shortness of breath please also contact your GP immediately.
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What Are Botox Treatments Like
Unlike other migraine treatments, Botox is given as a series of small injections directly into the muscle.
In a single treatment session, between 31 and 39 shots are given throughout seven different parts of the forehead, head , and neck . Each treatment cycle can last about 10 to 20 minutes. Its important that the correct sites are treated, or else the treatment may not be as effective.
Its recommended that a treatment cycle be given every 3 months in order to help control migraine attacks. How long you continue getting them will depend on how you respond to treatment. While many people improve with just one treatment cycle, some may require more. Most people seem to need fewer than three treatment cycles, but each person is different. Your doctor will work with you to see how long you should continue getting treatments and may recommend that you keep taking other medications until you see an improvement.