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William J. Binder M.D., F.A.C.S.
120 S. Spalding Drive, Suite 340
Beverly Hills, CA 90212
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BOTOX® for Migraines

In the United States, an estimated 28 million Americans (17% of women and 6% of men) suffer from migraines. Migraines are characterized by severe head pain (usually on one side) and is often accompanied by nausea and sensitivity to light and sound. Movement increases their intensity. They may last anywhere from a few hours to several days. Some people can sense them coming with visual disturbances like seeing pinpoints of light, although lacking that classic "aura" doesn't mean you don't have a migraine.

The most common treatment for migraines are painkiller medications which provide relief that lasts for several hours at most.  As many as 9 million of the estimated 28 million migraine sufferers in the US find no protection or relief from painkillers and studies have shown their overuse can have serious side effects including addiction.  Painkillers have not been shown to be effective to prevent migraines.

When administered correctly, BOTOX for Migraines has been shown to be an extremely well-tolerated and effective preventative therapy that can halt the onset of migraines for months at a time.

While conducting studies on BOTOX for wrinkle reduction in 1992, Beverly Hills Facial Plastic Surgeon Dr. William Binder noticed a correlation between the use of BOTOX and the alleviation of pain in his patients who also had migraine headache symptoms. Many reported either total elimination or decreased migraine pain following the BOTOX treatment. Dr. Binder then continued to study these effects for two more years and devised an initial protocol which was used in a combined multi-center, open label study to assess the efficacy of BOTOX in the prophylactic management of migraine headaches and related symptoms.*

Dr. Binder injects a series of small injections of BOTOX in specific areas across the frontal, temporal and glabellar regions of the forehead. In some instances, it is also injected into the back of the neck. The injection location and dosing are critical for achieving an effective, long lasting result that is free from undesired side effects. The treatment takes about fifteen minutes and it can provide pain relief for up to three or more months.

The exact way that BOTOX works to relieve migraines is not yet known. Botulinum toxins are known to have a blocking ability not only at the neuro-muscular junction but at the cellular level as well. It is suggested that BOTOX actually inhibits pain pathways through multiple actions at the neurotransmitter level and pain fiber level.

How does BOTOX compare to other migraine treatments?

BOTOX cannot be compared to other treatments. In those patients where Botox was effective, it eliminated pain and related symptoms of migraine (nausea, vomiting, photophobia, etc) for approximated 3 months. There is no other therapy that has this prophylactic ability. By way of comparison, the widely prescribed triptan class of agents (such as Imitrex® ) are commonly used as treatment only during or before an acute onset of migraine and have a duration of action for only hours.

Why is it important to have a qualified and experienced physician administer BOTOX for migraine headaches?

Although many physicians and even non-medical personnel can administer BOTOX for any purpose, the effectiveness and results can vary widely. Also, though rare, because of the muscle paralyzing effects of BOTOX, cosmetic side-effects can occur like droopy eye lid. Dr. Binder, who helped establish the injection protocols for both wrinkle and migraine treatments, says the injection locations and dosing are different for each condition. He says how much and where injections are placed are critical for achieving an effective, long lasting result that is free from undesired side effects.

*Results presented in January 1999 at the 15th Annual Scientific Meeting of the American Academy of Cosmetic Surgery (AACS); in May 1999 at the American Academy of Facial and Reconstructive Surgeons (AAFRS); in June 1999 at the Annual Meeting of the American Association for the Study of Headache (AASH) and in September 1999 at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS).

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William J.Binder M.D, F.A.C.S
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Dr. Binder developed treatment guidelines for the use of BOTOX on facial wrinkles and later discovered its pain relieving effect on migraine headaches.
 
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