title: OnabotulinumtoxinA for chronic migraine: a critical appraisal.
abstract: Chronic migraine (CM) is a severe disabling condition with a few available evidence-based management options. OnabotulinumtoxinA (onaBoNTA) is approved for use in a number of disorders. Its benefits and potential use in migraine were observed incidentally while treating patients cosmetically for wrinkles. The mechanism of action of onaBoNTA in CM is not fully understood, but there is evidence that this involves axonal transport via sensory fibers. The Phase III REsearch Evaluating Migraine Prophylaxis Therapy trials have established the efficacy as well as the long-term safety and tolerability of onaBoNTA in CM. This review will discuss the evidence behind its use in this setting.
authors.affiliation: Department of Neurology, Hull Royal Infirmary, Kingston Upon Hull, UK.
authors.forename: Rubesh
authors.initials: R
authors.lastname: Gooriah
authors.affiliation: Department of Neurology, Hull Royal Infirmary, Kingston Upon Hull, UK.
authors.forename: Fayyaz
authors.initials: F
authors.lastname: Ahmed
keywords: botox; botulinum toxin; chronic daily headache; migraine pathophysiology; migraine prophylaxis