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News Item Back to News Botox alleged to remove migraines Date: 12/12/2006 10:05 AM Excel Marketing Website Email

Botox has been used for years to improve looks and reduce the effects of ageing, but now the botulinum toxin is being increasingly used for treating various neurological diseases, primary among these being migraines.
A single injection of this miracle poison can keep at bay a migraine attack for 3-6 months, and even longer, if you are luckier. Says Sumidha Sen, who has been suffering from migraine for the last nine years, “I had tried all kinds of prescription drugs for my excruciating headaches. Finally, this year, I heard about this miracle injection that promised relief. And it has worked, I haven’t had an attack since I took the injection around eight months back.”

Agrees Dr Pahari Ghosh, professor, department of neurology, Vivekananda Institute of Medical Sciences, Kolkata, who treated Sen, “In some patients the effects last longer than expected. In the last one year, I have treated 40 patients with Botox, and though this is not a permanent cure, it definitely reduces the frequency and intensity of attacks.”

Not many know that the use of the toxin for the prevention of migraine came about accidentally. Plastic surgeons have been using Botox to treat wrinkles for a few years. Several patients who also happened to have migraines reported that their migraines improved following the injection of the toxin into forehead and brow muscles. Given that migraine occurs due to contracting of muscles, one reason could be that in motor nerve endings, botulinum blocks the release of acetylcholine, which tells muscles to contract. For headaches, it seems to work on sensory nerves as well — blocking pain but not deadening touch. It also controls the release of peptides that are major trigger for migraines.

The best part is that the effects of botulinum toxin A are reversible. Since the effect remains for about three months on an average, any potential side effects are also self-limiting. “While there are no side effects while treating migraine with Botox, the doctor should know where exactly to inject as it would paralyse the nerve endings there. However, problems like drooping eyelids or double vision which sometimes occur clear up on their own in around 15 days,” says Dr Sumit Singh, neurologist at the headache clinic at AIIMS.

Migraines constitute 16% of all headaches, with 10-20% of the general population in the country victim to this chronic headache and two-thirds of them never visiting a doctor for treatment. While women are more prone to it, 70% of women patients have a first-degree relative suffering from it. The most common triggers for migraine are specific foods like caffeine and chocolate besides hunger (don’t skip meals if you suffer from migraine), bright sunlight, disturbed sleep, physical exertion and psychological causes.

Dr JD Mukherjee, head of neurology, Institute of Neurosciences, Max Superspecialty Hospital, cautions saying that the toxin is used only in those cases where conventional treatment has failed. “Drugs like triptans are used under abortive therapy while betablockers, calcium channel blockers and anti-convulsants like sodium vaporates are used to prevent attacks in the conventional method of treatment. It is only when a patient does not respond to these drugs, that botulinum toxin A is used — one should remember it is not the first line of treatment,” he says.

While the term ‘botox’ is used generically, Allergan Inc. copyrighted the name for its Toxin A product. Its competitors are Myobloc, a Toxin B preparation from Elan Pharmaceuticals, and Dysport, a Toxin A from Ipsen, a British company.

Scientists are now testing botulinum toxin’s ability to treat stroke paralysis, facial tics, stuttering, lower back pain, incontinence, writer’s cramp, carpal tunnel syndrome and tennis elbow. “Our experience with 3,850 children affected with cerebral palsy injected with Botox in the past 7 years has revealed that about 62% of children had good to excellent recovery, 19% of children had satsifactory relief of spasticity but continued to have abnormal gait. Overall, 70% of children in our study became independent after Botox injection and physiotherapy,” Dr. (Prof) G P Dureja, Director, Institute of Spasticity Counselling & Management.

Wonderful image makeover for a deadly poison!