Status on the use of botulinum toxin for headache disorders.
OBJECTIVE
Reports and studies on botulinum toxin A in headache treatment are increasing. The studies available from reference systems and published congress contributions on the prophylactic treatment of idiopathic and symptomatic headache with botulinum toxin were analyzed with respect to the study design, the headache diagnosis, and the significance of results.


RESULTS
For the prophylactic treatment of tension-type headache and migraine, no sufficient positive evidence for a treatment with botulinum toxin A is obtained from randomized, double-blind, and placebo-controlled trials to date. For the treatment of chronic daily headache (including medication overuse headache), there is inconsistent positive evidence for subgroups (e.g. patients without other prophylactic treatment).


CONCLUSIONS
The majority of double-blind and placebo-controlled studies do not confirm the assumption that botulinum toxin A is efficacious in the treatment of idiopathic headache disorders. It is possible that subgroups of patients with chronic daily headache benefit from a long-term treatment with this substance. Future clinical trials should focus on these defined patient groups.
Evers
Stefan
S
Department of Neurology, University of Münster, Germany. everss@uni-muenster.de
D001905:Botulinum Toxins / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D020773:Headache Disorders / Q000188:drug therapy*; D006801:Humans; D010919:Placebos
D010919:Placebos; D001905:Botulinum Toxins