[Botulinum toxin type A in headache treatment : Established and experimental indications].
In recent years botulinum toxin type A has been used increasingly more in the treatment of specific headache disorders. Especially regarding chronic migraine with and without combined medication overuse, convincing randomized studies have proven the efficacy of this treatment option and have led to approval for this indication. Regarding other headache entities, such as episodic migraine, tension-type headache, trigeminal autonomic cephalalgia (TAC), neuralgic, neuropathic and myofascial pain, currently available scientific data on the efficacy of botulinum toxin type A are scarce and often ambiguous. The exact underlying mechanisms of the influence of botulinum toxin type A on the pathophysiology of headache are not completely clear but an influence on the release of calcitonin gene-related peptide (CGRP) seems to play a crucial role. This article summarizes the most important studies as well as experiences of treatment with botulinum toxin type A regarding different headache entities.
Migräne- und Kopfschmerzklinik Königstein, Ölmühlweg 31, 61462, Königstein im Taunus, Deutschland. c.gaul@migraene-klinik.de.
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Gaul
Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum Essen, Universitätsklinikum Essen, Essen, Deutschland.
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Holle-Lee
Klinik für Neurologie, Ludwig-Maximilians-Universität, München, Deutschland.
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Straube
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D006261:Headache / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D051271:Headache Disorders, Secondary / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D009465:Neuromuscular Agents / Q000008:administration & dosage; D012307:Risk Factors; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
Medication overuse; Migraine; Tension type headache; Trigeminal autonomic cephalalgia; Trigeminal neuralgia