title: Botulinum toxin A and headache treatment.
abstract: OBJECTIVE
  To determine whether botulinum toxin type A (BOTOX ) is effective for the prophylactic treatment of headaches in adults.
  
  
  METHODS
  A retrospective literature reviewwas performed. The outcome of various studies is discussed, including whether a decrease in the intensity as well as the occurrence of tension and migraine headaches was accomplished.
  
  
  RESULTS
  The approval for botulinum toxin A for the treatment of migraine was based largely on the results of Allergan's PREEMPT Phase III trial. The study demonstrated a statistically significant decrease in the frequency of headache days and a reduction in total headache hours in the treated group vs placebo. There have been several other randomized trials looking at treatment of chronic tension type headaches with botulinum toxin A therapy. Most studies show no difference in headache intensity between groups at anytime. Current concepts of the pathophysiology of tension-type headaches would suggest Botox to be a reasonable and likely effective treatment. However, its effectiveness in treatment of chronic migraine and tension-type headaches remains debatable.
  
  
  CONCLUSIONS
  The literature currently suggests a modest effect, if any, with the use of botulinum toxin A for the prophylactic treatment of chronic migraine and tension-type headache, and further prospective, randomized, double-blinded studies are needed.
authors.affiliation: University of Connecticut, CT 06708, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Gady
authors.forename: Elie M
authors.initials: EM
authors.lastname: Ferneini
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D008881:Migraine Disorders / Q000517:prevention & control*; D009498:Neurotoxins / Q000627:therapeutic use*; D018781:Tension-Type Headache / Q000517:prevention & control*
chemical_list: D009498:Neurotoxins; D019274:Botulinum Toxins, Type A