A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of tension-type headache.
Tension-type headache (TH) is a common condition, the pathophysiology of which remains undetermined. Evidence implicates sustained contraction of pericranial muscles to be a major cause. A recent preliminary study demonstrated the effectiveness of botulinum toxin type A (BTX-A) in patients suffering from chronic TH. To further investigate this, we performed a study to compare the efficacy of BTX-A with the steroid methylprednisolone (both administered with the local anesthetic lidocaine), when administered by injection into the tender points of cranial muscles in patients with TH. A significant decrease in the median pain score (assessed using a standard visual analogue scale ) was observed at 60 days post injection of BTX-A compared with the pain score achieved following steroid therapy. All patients treated with BTX-A experienced a gradual decrease in median pain severity scores at 30 days and 60 days post treatment. The beneficial effects of BTX-A therapy continued to improve 60 days following injection, whereas the effects of steroid therapy at this time point began to decline. This study clearly demonstrates the effectiveness of BTX-A for the treatment of TH.
Porta
M
M
Pain Center, Department of Neurology, Policlinico San Marco, Centro Terapia del Dolore, Corso Europa 7, 24040 Zingonia/Bergamo, Italy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D018781:Tension-Type Headache / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; D008775:Methylprednisolone