Botox soothes headaches

Botox, the injected toxin that can smooth a wrinkled forehead, can also soothe an aching head.

Several studies presented at a meeting in Seattle of the American Headache Society show that specially targeted injections of Botox can ease the pain of several types of headache, including migraine and tension headache.

An estimated 28 million people in the United States have migraines, and about 10 million have chronic daily headaches, meaning they have headaches at least 15 days a month.

The Botox connection was discovered by accident by a doctor injecting patients to get rid of wrinkles. Many insisted their headaches had also disappeared.

Dr B. Todd Troost, a neurologist at the Wake Forest School of Medicine in Winston-Salem, North Carolina, who led one of the studies, said that this made sense. The same mechanism that smooths out wrinkles kills pain transmission.

"Botox takes care of both things," he said. "Yes, it relaxes muscles but let's figure out why it relaxes muscles. It interferes with little packets of neurotransmitters."

These message-carrying chemicals move between nerve cells, and several are associated with pain and muscle control.

Dr Troost said Botox, a purified form of the toxin that causes botulism food poisoning, also interferes with substance P, a protein associated with pain.

Migraine has been shown to be a build-up of a cycle of pain.

Some studies have suggested that if the pain can be stopped early, a patient never progresses to a full-blown migraine.

"Some people with migraine don't seem to respond very well to the various medications available," Dr Troost said, but Botox, made by Allergan, may nip this mechanism in the bud.

"It relaxes the muscles, seems to break up the migraine cycle," said Dr Troost.

"Many, many of my patients have told me, 'Gosh, my migraine seems to get triggered when I get this back spasm'," he said.

Dr Troost said he saw no reason why patients should not get a Botox headache treatment and a cosmetic procedure to relax wrinkles at the same time.

"Of course you should, because 80 per cent of your patients are women. They appreciate getting rid of wrinkles and crow's feet.

"It takes another 30 seconds."

Another beneficial side-effect - patients stop taking pain pills, which in turn reduces so-called rebound headaches often caused by the regular use of aspirin and other analgesics, Dr Troost said.

A team at the Houston Headache Clinic said that 112 patients with untreatable chronic migraine were given one to five cycles of Botox injections.

They reported a 75 per cent reduction in migraine-associated disability, days with headaches and use of drugs.

Before treatment, they took an average of 26.5 headache pills a month, but this dropped to 4.2 pills a month after Botox.

"The biggest advantage to Botox is its lack of side-effects, especially compared to other medications," Dr William Ondo, an assistant professor of neurology at the Baylor College of Medicine, in Houston, said.

The treatment is not cheap - each injection cycle costs about US$1000 ($2100).

And it does not always work.

"Most of our patients had either a great response, or no response at all," Dr Eric Eross of the Mayo Clinic in Scottsdale, Arizona, said.

- REUTERS

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