Botox® for the Prevention of Chronic Migraine

In the clinical trials for Botox® for chronic migraine, approximately 9% of patients reported neck pain after the procedure (as there are some injections into the trapezius muscles and high cervical spine). This tends to be short-lived, lasting just a few days. About 6% reported a headache and/or migraine after the procedure (potentially from the injections themselves, not the actual Botox®). About 3% reported ptosis (AKA drooping) of the eyebrow or eyelid after the procedure. This is typically related to the injection points right between the eyebrows and on the forehead. Should such a side effect occur, the effects are not permanent, but could last up to 90 days while the Botox is “active.” With time, as the Botox® wears off, the ptosis/drooping would be resolve, but there is no “antidote” per se to speed up the process.

Botox® often takes time to start working. The first treatment can be very limited in its benefit and would have no bearing overall on how this therapy may work for an individual. Often, it takes 2-3 treatments to start to see results, and these treatments are separated by 12 weeks. This means it could potentially take upwards of 6-9 months to start to see ideal results. While it does take time for the Botox® to start to help, the benefits continue to grow with time. There is data to suggest that with each subsequent Botox® treatment you would expect to see continued improvement. Studies (COMPEL trial) have shown such improvement all the way out to two years of ongoing treatments. We have seen Botox® to be highly effective for some patients for decades.