Botulinum toxin A in Patients with Chronic Migraine: A Single-Center Experience;

Abstract

Abstract: Objective : The Botulinum toxin A (BoNT/A), increasingly used in many fields in recent years, was shown to be effective in chronic migraine (CM) in recent studies. In this study, we aimed to investigate treatment response in our CM patients who underwent BoNT/A therapy. Methods: The study included 41 CM patients (aged 18-65 years). We questioned patients undergoing BoNT/A therapy regarding demographic characteristics, education level, time of diagnosis, migraine triggers, and previous therapies at first visit prior to injection. The patients were assessed together with analgesic use, visual analog scale (VAS) score and Migraine Disability Assessment Score (MIDAS) rating at month 6 after treatment. Results: There were 36 women (87.8%) and 5 men (12.2%) in the study group. Mean age was calculated as 44.88±10.51 years. Of the patients, 20 patients (48.8%) fulfilled criteria for migraine with aura while no aura was detected in 21 patients (51.2%). Significant decrease was detected in MIDAS rating and VAS scores after BoNT/A therapy (p<0.001). Conclusion: The BoNT/A was found to be effective and safe in the prophylactic treatment of chronic migraine. The BoNT/A is a potent treatment that could be performed by experienced neurologists in eligible CM patients regardless of previous prophylactic treatments.

Keywords

• Baş ağrısı
• Kronik migren
• Botilinum Toksin A

Kronik Migrenli Hastalarda Bir Kliniğin Botulinum toksin A Deneyimi

Abstract

Amaç : Son yıllarda her alanda kullanımı artan Botulinum toksin A (BoNT/A)’nın yapılan son çalışmalarla etkinliği kronik migrende de (KM) gösterilmiştir. Nöroloji kliniklerinde de uzun yıllardır Fokal Distoniler, Distoni olmayan istemsiz hareket bozuklukları, Spastisite, Otonom Sinir Sistemi bozuklukları gibi kullanımlardan sonra KM de kullanımı hızla yayılmaktadır. Bizde bu çalışmamız ile KM tanısıyla takip ettiğimiz BoNT/A uygulanan hastalarımızın tedavi yanıtlarını incelemeyi amaçladık. Gereç ve Yöntem: Kronik Migren tanılı, ülkemizdeki ruhsatlı tedavi seçeneklerini kulanmış olmasına rağmen yeterli yanıt alınamayan, 18-65 yaş arası ve ek nörolojik hastalığı olmayan 41 Kronik Migren (KM) hastası çalışmaya dahil edildi. BoNT/A tedavisi alan hastalar enjeksiyon öncesi ilk vizitlerinde demografik bilgiler (yaş,cinsiyet), eğitim durumu, tanı zamanı, migren tetikleyicileri, aldıkları tedaviler açısından sorgulandı ve tedavi sonrası altıncı aylarında analjezik kullanımı, atak sıklığı, VAS (Vizuel Analog Skala) ve MIDAS (Migren Özürlülük Değerlendirmesi) skorları ile birlikte değerlendirildi. Bulgular: Hastaların 36 (%87.8) kadın, 5 (%12.2) erkekti. Yaş ortalaması 44.88±10.51 olarak saptandı. Migren hastalık süresi ortalama 15.75 yıl idi. Hastaların 25 (%61)’inde birinci derece akrabalarında aile öyküsü varken 16 (%39) hastada yoktu. Hastaların 20 (%48.8)’i auralı migren kriterlerine sahipken, 21(%51.2)’inde aura saptanmadı. Hastaların BoNT/A tedavisi sonrası MIDAS ve VAS skorlarında anlamlı düşme saptandı (p<0.001). Sonuç: KM’nin proflaktik tedavisinde etkin ve güvenilir bulunmuştur. Hastaların migrene bağlı özürlülüğünün azaldığı ve yaşam kalitesinin arttırdığı saptanmıştır. Tüm proflaksi tedavilerini alan KM’li uygun kriterli hastalarda BoNT/A deneyimli nöroloji uzmanlarınca uygulanacak güçlü bir tedavidir.

Keywords

• Baş ağrısı
• Kronik migren
• Botilinum toxin A

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