A Publication of the East Bay Headache Support Group
A Member of the American Council for Headache Education
(ACHE) Support Group Network
VOLUME 7, ISSUE
A Publication of the East Bay Headache Support Group
A Member of the American Council for Headache Education
(ACHE) Support Group Network
VOLUME 7, ISSUE
July 9th Meeting: Use of Botox Injections as a Treatment for Headaches
I thought I had heard it all—People who suffer from headaches will try almost anything to rid themselves of the pain. But submitting to injections of botulinum toxin, the same bacterium that causes food poisoning, in hopes of reducing one’s headaches? That’s crazy! Or is it?
Botulinum Toxin Injections (BTI), also referred to as Botox or Myobloc, were first used to treat neurological disorders in the late 1960s; then became popular as a non-surgical cosmetic procedure to smooth facial wrinkles. But, after some patients noted their headaches were also improved, this radical-sounding treatment is becoming all the rage as a preventive for several types of headaches, including migraine and tension headaches.
Michael Stein, M.D., will speak to the support group on July 9, bringing the latest information about Botox injections. Dr. Stein has a private neurology practice in Walnut Creek, where he specializes in aiding headache patients to gain control over their symptoms; with Botox injections being part of his arsenal to prevent headaches. Dr. Stein is also co-founder and medical advisor to the East Bay Headache Support Group.
We will meet in the Ball Auditorium downstairs at John Muir Medical Center from 7:30 to 9:00 p.m. on Tuesday, July 9. For more information, call 925-228-1084.
Recent News About Botox Studies in the Treatment of Headaches
Small amounts of the most deadly toxin known to man are proving effective at preventing debilitating headaches. At a press conference prior to the annual meeting of the American Headache Society, held in Seattle earlier this month, Todd Troost, M.D., reported success rates as high as 92 percent using injections of botulinum toxin to treat patients who didn’t respond to headache medications.
"Botox is becoming one of the main preventive therapies for headache," said Troost, professor and chairman of neurology at Wake Forest University Baptist Medical Center in North Carolina. Dr. Troost has treated more than 350 patients with Botox. "When it is effective, the need for daily medications or acute medicines for severe attacks is significantly reduced or eliminated."
Botox, a purified form of the toxin that causes botulism, partially paralyzes muscles for about three months. For headache treatment, it is injected into muscles around the eyes and forehead and sometimes the jaw.
For patients whose headaches involve the entire head, additional injections are given in the back of the neck and shoulders.
For his study, Troost evaluated 134 patients with migraine headaches, tension headaches or chronic daily head-aches. A majority of the patients had already been treated with at least three headache medications without success.
Patients had from one to four Botox treatments at three-month intervals. Overall, 84 percent of patients reported improvement. "There were significant improvements that appear to be progressive and may also be cumulative," said Troost. "I tell patients that it is important not to give up if it has only a mild effect the first time. The second or third time it really seems to work better."
And a team from the Houston Head-ache Clinic told the headache meeting about their study, where 112 patients with untreatable chronic migraine were given one to five cycles of Botox injections. They reported a 75% reduction in migraine-associated
disability, days with headaches, and use of drugs. Before treatment, these patients took an average of 26.5 headache pills a month, but this dropped to 4.2 pills a month after Botox treatments.
In presenting a third study on Botox at the American Headache Society meeting, Dr. Eric Eross of the Mayo Clinic in Scottsdale, Arizona said, "Most of our patients had either a great response, or no response at all." He reported that 28 of 48 migraine patients had a 50% or greater reduction in migraine-related disability.
Sources: Science Daily Magazine/University of Toronto - http://www.sciencedaily.com and Reuters Health Information - http://www.ivillagehealth.com
Solutions to the Vacation Headache...
Time off from work and from the
everyday routine is not time off from headaches. The following solutions to the problem of the vacation headache were excerpted from the Summer 1996 issue of Head-aches, the newsletter of the American Council for Headache Education, and from an article in the Rocky Mountain Headache Association Newsletter, 1992. Also, a few ideas were added by this editor.To reduce the stress of preparing for vacation:
Make and use a trip list. Make time reminders and a suitcase list.
Schedule a one-day unwinding period between work and travel.
Watch yourself for signs of tension (clenched teeth, tensed shoulders, shallow breathing). Relax those muscles and take slow, easy abdominal breaths.
To ease the stress and physical discomfort of travel:
Allow plenty of time to get to the airport or your destination.
Check your luggage (but always carry your headache medications and other comfort items in a carry-on bag).
If driving, plan to arrive at your destination before dark. Plan out your route and avoid traveling during high commute times.
Wear sunglasses, use pull-down sun screens on the car windows, or even get the windows tinted (Check first with DMV to see what tints are legal in California).
If traveling by car, make frequent stops to stretch, walk around, and generally relax. If flying, reserve an aisle seat and get up and walk periodically.
Do gentle neck relaxation exercises every hour.
Cluster headache sufferers can get a doctor’s written request that oxygen be available to abort an attack during the flight.
To avoid disruption of normal eating and sleeping patterns, try the following:
Reserve a special meal in advance of the flight—vegetarian entrees or fruit plates are safe choices (always watch out for MSG!).
Pack healthy snacks to avoid missing a meal.
If crossing time zones, try to adjust to the local time as quickly as possible. Ask your doctor about sleeping pills or melatonin to relieve jet lag.
Other ideas:
Your prescribed medications should always be carried in their original containers.
Try taking a non-steroidal anti-inflammatory (NSAID) medication as a headache preventive.
In the event you need to visit an Emergency Room, carry a letter from your doctor indicating your headache diagnosis and including recommended abortive medications.
Disability: When Migraines STOP You
No disabling condition makes life easy. Nor are they easily understood. Migraine, however, is less understood than most. To others, migraine is often viewed as "just a headache." Even the most caring of friends and families sometimes just "don’t get it." Those who do understand watch helplessly as their loved ones suffer tremendous pain.
You can help your friends and family by obtaining and sharing with them educational materials about migraine. There are also some online webcasts regarding migraine that can be quite helpful. There are many excellent web sites for educational materials.
In the workplace, people view co-workers who wear sun glasses, visit the restroom often, slur their speech, take medications often, miss work frequently, or exhibit other such behaviors as possible drug or alcohol abusers or possible slackers. Even in the best of work conditions, the pain and emotional effect of migraine can cause a level of disability that makes it impossible for a person to continue their employment.
Of migraine and disability, Dr. Fred D. Sheftell, founder and director of the New England Center for Headache said, "Historically, patients with the most intractable migraines experience a downward spiral in terms of income and contributions to society at large." One of the more recent studies on the impact of migraine showed the U.S. unemployment rate of migraineurs to be 10% - 20%, which is far higher than the general population. Data from the Migraine Association of Canada indicates migraine causes an annual loss of nearly 500 million dollars in the workplace.
Many employers are quite willing to make accommodations for migraineurs in the workplace. Different lighting, glare screens for computers, flex-time scheduling and other [improvements] can make it possible for some migraineurs to work around their migraine attacks and continue working. Partly because migraine is so misunderstood, some employers are not willing to make those accommodations. In some workplaces, such as industrial settings, there are safety issues that must be considered as well.
There are some things that migraineurs can do to better handle migraine at work:
Be prepared. Always have medications with you. Find out in advance if there is someplace at work where you can rest quietly if a migraine strikes at work.
Scope your work environment for possible environmental triggers.
Talk to your employer/supervisor before a migraine strikes you at work. You may find it helpful to have your doctor give you a letter to take to work explaining that migraine is a neurological disorder. This lets your boss know in advance that you are conscientious and not just calling in to take the day off.
Don’t be embarrassed or try to hide your migraines. The more others know about your migraines, the more understanding they will be.
Unfortunately, for some migraineurs, no matter how good their treatment regimen is, their migraines will cause varying levels of disability, perhaps severe enough to compromise their ability to earn a living. Assessing the level migraines impact one’s life is quite helpful to doctors in evaluating treatment plans. It will also be necessary if the patient is going to apply for disability benefits. One method of measuring the level of migraine impact is the Migraine Disability Assessment Questionnaire (MIDAS). This simple survey is available through the American Council for Headache Education (ACHE). Visit their Web site at http://www.achenet.org.
Found on the Internet at www.headaches.about.com
Thank you for reading HEADLINES, provided by the East Bay Headache Support Group.