New Study Suggests that Botox is working for Chronic Migraine, but …

1160 patients across Europe were a part of a recent study to see just how effective onabotulinumtoxinA (sometimes sold under the brand name Botox) was in treating patients with chronic migraine. We all hear stories, but if you take a large sample, what are the results?

First, a little background. This group was 15.8% male and 84.2% female. The mean age was 46.6 years old. About half of them had used Botox before. The study had data from over 4000 treatments.

The basic good news was that most patients – 74.4% – were satisfied or even extremely satisfied with their treatment.

This tells us that the treatment is helping, but not how much it’s helping. But for those who are curious, the treatment usually involved about 31 injection sites and a dose of 155 U. Treatments tended to be about 13-14 weeks apart, or just over 3 months.

The most commonly reported side effect was neck pain.

As we have talked about before, onabotulinumtoxinA treatment is helping migraine patients, but there is reason to believe it could be helping a lot more. There are a lot of variables that we would like to know more about. Which type of migraine is most responsive to this treatment? Which injection sites are the best? Could we get the same results with a lower dosage?

Now that we’ve seen the data, what’s your experience? Leave a comment!

Read more about this study: Utilization and safety of onabotulinumtoxinA for the prophylactic treatment of chronic migraine from an observational study in Europe

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Answering Your Question: Eye Concerns, Yoga, and What To Do When You’ve Tried Everything

I decided to answer a few of your recent questions in this podcast. If you have a question, visit Headache and Migraine News (if you’re not there already!) and click the button on the right sidebar.

Here are a few of the articles that are related to this podcast:

Thanks for listening!

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Pioneering Stem Cell Research for Migraine

A study published earlier this year is raising questions about the use of stem cells for the treatment of migraine. Although the results weren’t spectacular, they do show promise. Let’s see why.

This was only a small open-label study. 9 people (8 women and 1 man) were enrolled. Stem cells were taken from the patient, tested for viability, and then injected into the temporalis, occipitalis, neck, and trapezius muscles.

Stem cells & Migraine

Now, this is going to be one of those good-news-bad-news things, so bear with me.

Obviously this was just a small study. However, the good news is that 7 of the patients did see a decrease in their MIDAS score. MIDAS is a test designed to measure the disability caused by your migraine attacks (read more about MIDAS here). Scores decreased overall by almost 28%.

So that’s great news. However, for most of those patients, the improvement was fairly small. And for all of them, it was temporary (although the study only lasted three months).

For two of the patients, the improvement was quite significant.

But don’t worry, there is more good news. These were patients who generally had suffered with migraine for a long time, and had tried many other treatments. The mean age was 48, and the mean number of years with migraine was 16. They had all tried at least three preventative medications and also had tried onabotulinumtoxinA (Botox).

So these 9 patients were not the easy-to-treat kind. The fact that two saw significant improvement is important.

We’ve talked about stem cell research for migraine and headache before. If this treatment could help even a quarter of hard-to-treat patients, it would be a major breakthrough.

You can read the full study here: Stem Cells in the Treatment of Refractory Chronic Migraines

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Earplugs for Weather Migraine?

Last year Cirrus Healthcare released a new type of drug-free migraine treatment. Building on their experience with products related to barometric pressure, Cirrus is promoting earplugs to fight weather-related migraine.

The earplugs, made from “soft, hypoallergenic, latex-free silicone”, are designed to help regulate the pressure in your ears. They’re actually similar to their popular “Earplanes” (made for both adults and children), which help travellers avoid ear pain during airplane flights.

MigraineXThis product, called MigraineX, is designed to be worn usually for 2-4 hours when there are significant changes in barometric pressure. These are actually specially-designed earplugs, which means they will block a certain amount of noise as well (though not as much as some other plugs). This could be an additional selling point, depending on your situation. But for most people, if they can avoid the pitfalls of weather changes, and lower the volume in the environment, all the better.

The manufacturer does refer to a very positive study that was done with their product, although I was unable to find the details. But you will see that there are a lot of positive reviews (although, like any migraine treatment, they by no means work for everyone).

Have you tried MigraineX, or Earplanes? What was your experience like?

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After My Headache: Migraine Postdrome in Children

Detecting migraine in children is a challenge, and there is a lot that we simply do not understand about how migraine attacks affect this population. A new study out of France is answering a question many did not even think to ask – what are some of the symptoms that children and adolescents experience after the main attack (which usually features a headache)?

100 children and adolescents with migraine were interviewed by phone. They were asked specifically about symptoms that began after the headache phase of the attack, as well as symptoms that simply continued afterwards. (See study abstract: Postdrome symptoms in pediatric migraine)

Sleepiness - common postrdrome symptom91% reported symptoms that persisted after the attack. Here are the ones that were the most common:

  • Asthenia (weakness and/or a lack of energy)
  • Cognitive difficulties (trouble thinking)
  • Pallor (paleness)
  • Cognitive slowing (slow/foggy thinking)
  • Loss of appetite
  • Sleepiness/drowsiness
  • Nausea

“True postdrome” refers to symptoms that actually start after the headache phase. The most common symptoms in this category, reported by 82% of patients, were:

  • Thirst
  • Sleepiness/drowsiness
  • Visual disturbances
  • Food cravings
  • Paraesthesias (sensations such as “pins and needles”)
  • Eye pain

For most patients these symptoms lasted less than 12 hours.

This is an absolutely fascinating study that will help both adults and children understand migraine symptoms better. The postdrome is very common. There is so much focus on the headache that we often miss the other symptoms, some of which are quite debilitating. Recognizing these symptoms in children (and adults) will not only help us recognize migraine, but also treat it in a more understanding way.

We’ve also talked about warning signs of migraine in children. You’ll want to check that out too.

If you have a child with migraine, have you noticed any of these? Adults, have you noticed any of these symptoms in yourself? Leave a comment and let’s talk about it.

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