Botulinum bacteria produce toxins that can cause serious and even deadly illness if they enter the body through wounds or contaminated food. But when purified and used in tiny amounts, botulinum toxin type A has several beneficial medical and cosmetic uses due to its ability to temporarily paralyze small muscles. The best known example is Botox, the botulinum toxin marketed by Allergan, Inc., thats used cosmetically to smooth countless brows and wrinkles. Now comes evidence that Botox may do more than make some people look better — it could also make them feel better by preventing painful migraine headaches.
Migraines (http://emedicine.medscape.com/article/1271380-overview), which strike about 28 million Americans, can cause excruciating, throbbing pain that can result in lost work days and disrupted relationships. Prescription medications often help but Botox might not only relieve pain but even keep migraines at bay. Thats the conclusion of a preliminary study published in the February issue of Archives of Dermatology.
Christine C. Kim, M.D., formerly of SkinCare Physicians, Chestnut Hill, Massachusetts, and now in private practice in Encino, California, and her research team studied 18 patients with an average age of 50 who suffered from migraine headaches. All had either received Botox injections for cosmetic reasons or they were scheduled to have the treatments. Ten of the research subjects had what the researchers dubbed imploding headaches — described as crushing and vice-like — or ocular headaches, marked by severe pain centered in an eye. Nine other research participants had exploding-type headaches that involved a feeling of pressure building inside their heads. Some patients experienced more than one of these types of migraines.
Three months after receiving Botox, 13 of the patients reported a reduction in migraine pain, including 10 who had suffered from imploding or ocular headaches and three who had experienced exploding headaches. The six research subjects who didnt respond to the injections all had the exploding-type pressure headaches.
When the researchers evaluated the people who did respond to the Botox treatment for headaches, they discovered migraine frequency overall was dramatically reduced — dropping from an average of 6.8 days per month to less than one day per month. The research subjects with imploding or ocular headaches experienced the most relief while the patients with exploding headaches experienced a lesser but still significant reduction in headaches with their migraine attacks decreasing from 11.4 to 9.4 days per month.
So whats going on here? The scientists noted in their study that the fact botulinum toxin produces muscle paralysis doesnt adequately explain how it may prevent migraines. They pointed out that research suggests Botox affects the way pain signals travel through the nervous system and it could be that Botox halts migraines by blocking pain receptors or reducing inflammation.
“These preliminary data are intriguing, and our results provide support for the hypothesis that patients with migraine that is characterized by imploding and ocular headaches are more responsive to botulinum toxin type A than those with migraine characterized by exploding headaches,” the authors stated in their paper. “Our findings invite consideration of using botulinum toxin type A injections to prevent migraine headaches and may promote the role of the dermatologist in the treatment of patients with migraine. However, well-controlled trials need to be conducted to confirm these findings.”
Physicians are already using botulinum toxin type A for other medical applications, including the correction of crossed eyes and to eliminate excessive sweating (hyperhidrosis). Ongoing studies are examining whether its an effective treatment for cervical dystonia (a neck muscle disorder that pulls the head out of position), too.