Botulinum toxin therapy of migraine and tension-type headache: comparing different botulinum toxin preparations.
Most of the initial reports on botulinum toxin in tension-type headache (TTH) and in migraine were positive. Unfortunately, these results were not reproduced in well-designed, randomized controlled trials. So far, doses from 20 U (Botox) to 500 U (Dysport) have been studied in patients with chronic TTH, and doses from 16 to 200 U (Botox) in patients with migraine. Overall, there is no evidence for a beneficial effect of botulinum toxin, although trends favoring botulinum toxin were reported. Experience with botulinum toxin type B (Myobloc/NeuroBloc) is limited and similar to the experience with the type A. Thus, a widespread use of botulinum toxin therapy in headache can currently not be recommended.
Schulte-Mattler
W J
WJ
Department of Neurology, University of Regensburg, Regensburg, Germany. wilhelm.schulte-mattler@klinik.uni-regensburg.de
Martinez-Castrillo
J C
JC
D018726:Anti-Dyskinesia Agents / Q000145:classification / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000145:classification / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008881:Migraine Disorders / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D018781:Tension-Type Headache / Q000188:drug therapy*
D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A