Botulinum A for migraine

This guideline advises that Botulinum A toxin injection can be considered for the management if migraine if the patient has:

  • Not responded to at least 3 prior therapies AND
  • Been appropriately managed for medication overuse AND
  • Headaches on at least 15d per month AND
  • Migraines on at least 8d per month

Treatment should be stopped if:

  • There is inadequate response (less than 30% reduction in headaches after 2 cycles)
  • Headaches change to occurring on less than 15d per month for 3 consecutive months

 Procedure:

Up to 39 sites can be injected. Treatment is repeated every 12 weeks. It costs about £350 per treatment (including staff time and drug).

Louise Hudman

I'm a freelance GP locum in Winchester & Southampton.

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