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Why We Say Yes

Avi Ashkenazi, MD; Stephen Silberstein, MD, FACP

Arch Neurol. 2008;65(1):146-149.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Botulinum toxin type A (BoNT-A) has long been used to treat disorders associated with increased muscle tone. Support for an analgesic effect of BoNT-A independent of its muscle relaxation effect came from clinical observations that some patients with dystonia obtained pain relief before they obtained improvement in muscle tone.¹ Injections of BoNT-A were discovered serendipitously to alleviate migraine headache when they were given for the treatment of facial wrinkles.² After several open-label studies showed that BoNT-A might have efficacy in headache treatment, randomized controlled trials were initiated to investigate this issue further.³ New scientific data have provided insight into mechanisms by which BoNT-A may exert its analgesic effect. In our discussion, we focus on clinical data obtained from randomized controlled trials.

CLINICAL STUDIES

BoNT-A for the Treatment of Episodic Migraine

Silberstein et al⁴ examined the effect of BoNT-A on 123 patients with International Headache Society–defined migraine in a randomized, vehicle-controlled study. Either . . . [Full Text of this Article]

BoNT-A for the Treatment of Chronic Daily Headache

BoNT-A for the Treatment of Chronic Tension-Type Headache

Possible Mechanisms of Action for BoNT-A in Headache Prevention

ASSESSING THE DATA SO FAR
Patient-Related Factors

Treatment-Related Factors

AUTHOR INFORMATION
Author Affiliations: Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

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