Our Experience in the Application of Botulinum Toxin Type A in Medically Resistant Chronic Migraine Patients

Abstract

Objective: Botulinum toxin type-A has been recognized as a well-tolerated option for the preventive treatment of chronic migraine. The aim of this study is to evaluate the effect of botulinum toxin administration in frequency and severity of headache attacks , and also to show the changes in the effectiveness with repetative botulinum toxin applications in patients with chronic migraine. Material and Methods: Data of 29 patients with migraine who were administered botulinum toxin-A at a three-month interval were collected. We evaluated demographic data, monthly attack frequency, and attack severity before treatment, and duration of drug effectiveness. Results: A significant improvement was found in the monthly frequency of migraine attacks (21.7 vs. 11.4 days) and in the Numerical grading score (9.2 vs. 5.6) when compared pre- botulinum toxin type A application period with after the third application period (p < 0.001). The duration of botulinum toxin activity was found to be 3 months and 18 days after the first application, 3 months and 7 days after the second application, and 4 months after the third application. Conclusion: This study showed a decrease in the frequency and severity of headache attacks in patients with chronic migraine who received Botulinum toxin type-A. As the number of applications increased, there was an increase in the pain-free time of the patients.

Keywords

• Botulinum neurotoxin A
• Chronic migraine
• Numeric rate scale

MEDİKAL TEDAVİYE DİRENÇLİ KRONİK MİGREN HASTALARINDA BOTULİNUM TOKSİN TİP A UYGULAMASINDAKİ DENEYİMLERİMİZ

Abstract

Amaç: Botulinum toksini tip A, kronik migrenin önleyici tedavisi için iyi tolere edilen bir seçenek olarak kabul edilmiştir. Bu çalışmanın amacı, kronik migren tedavisinde botulinum toksin uygulamasının baş ağrısı atak sıklığını, atak şiddetini ve uygulama sayısı artıkça etkinliğinin nasıl olacağını değerlendirmektir. Gereç ve Yöntemler: Medikal tedaviye dirençli kronik migren hastalarından üç ay arayla botulinum toksin A yapılmış hastalardan toplam 29 hastanın verisi toplandı. Demografik verileri, tedavi öncesi aylık atak sıklığı, atak şiddeti, ilacın etkinlik süresini karşılaştırıldı. Bulgular: Botulinum toksini tip A uygulama öncesi ile üçüncü uygulama sonrası karşılaştırıldığında, migren ataklarının aylık sıklığında (21.7 'e karşı 11.4 gün) ve Nümerik derecelendirme skorunda (9.2 'e karşı 5.6) önemli ölçüde iyileşme bulundu (p<0.001). Botulinum toksin etkinliğinin süresi ilk uygulama sonrasında ortalama 3 ay 18 gün, ikinci uygulama sonrasında 3 ay 7 gün, üçüncü uygulama sonrasında 4 ay olarak bulundu. Sonuç: Bu çalışma, Botulinum toksini tip A uygulanan kronik migrenli hastalarda baş ağrısı atak sıklığında ve şiddetinde azalma gösterdi. Uygulama sayısı artıkça hastaların ağrısız gecen sürelerinde de artış bulundu.

Keywords

• Botulinum nörotoksin A
• Kronik migren
• Numerik derecelendirme skoru

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