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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Botox--report on use/effectiveness
        
(Message started by: Bob_Johnson on Oct 15^th, 2003, 6:43am)

Title: Botox--report on use/effectiveness
Post by Bob_Johnson on Oct 15^th, 2003, 6:43am

Curr Treat Options Neurol. 2003 Nov;5(6):483-492.

The Use of Botulinum Toxins for Chronic Pain and Headaches.

Argoff CE.

Cohn Pain Management Center, North Shore University Hospital and New York University School of Medicine, 4300 Hempstead Turnpike, Bethpage, NY 11714, USA. pargoff@optonline.net

The use of botulinum toxin in the management of various neurologic and non-neurologic disorders has grown considerably over the past decade. At the same time, new information regarding the mechanism of action of these toxins has evolved allowing for a greater understanding of the versatility of these agents. Although two types of botulinum toxin (type A Botox and type B Myobloc ) are commercially available in the US, most studies of the use of these toxins for the management of chronic pain and headache have been completed with type A. Data from open-label and retrospective studies as well as clinical practice suggest as strongly as possible that there is a role for these agents, especially Botox, in the management of several chronic headache disorders, including chronic migraine, chronic tension-type, cervicogenic, and cluster headache. Emerging data regarding the use of these agents for so-called "analgesic-rebound" headache also appear impressive; however, as of yet, no multicenter, randomized, controlled studies for any headache type have been published that confirm the results seen in noncontrolled studies. Nevertheless, the benefit that some patients experience from this agent is impressive, and this drug appears for many to modify the disorder in a very positive manner. In a similar fashion, data for other pain states are often restricted to open-label and case study approaches; however, clinical experience and some of the available studies (even small controlled studies) suggest a role for the toxins in the management of various chronic pain states, such as myofascial pain, low back pain, and neuropathic pain. One of the greatest challenges ahead for all interested in this area is confirming the benefit seen clinically through appropriately designed multicenter, randomized, controlled studies.

PMID: 14516525 [PubMed - as supplied by publisher]

Title: Re: Botox--report on use/effectiveness
Post by Karla on Oct 15^th, 2003, 7:30am

I did the botox thing and it did wonders for my migraines but did nothing for my ch. I am scheduled to go in again for more injections on 10/22 I can't wait so the migraines stop again. Have to wait for my insurance to preapprove which takes time and always makes me late getting my treatments.

Title: Re: Botox--report on use/effectiveness
Post by Zonie on Oct 29^th, 2003, 10:09pm

My new neurologist, which I saw on Monday, mentioned that we may try the botox on down the line in my treatment. But this was one of many meds that he named as a possible cocktail for the future treatment while disposing of the ineffective ones that we do try.

If and when that day comes, I'll let you know how it works. I was quiet impressed with my new dr as he seemed to be on top of the latest treatments that are discussed here on our board. He mentioned several to me, and he was also quiet impressed with my little "red" file folder of info that I had taken with me from OUCH. He had never heard of us, but thought it was great that we share our info.

Let us hear more about the Botox if you decide to go with it. Good Luck.

Zonie

Title: Re: Botox--report on use/effectiveness
Post by LasVegas on Oct 30^th, 2003, 9:33am

Where are the injection sites for a CH? How much dosage is effective for those who have had relief from this medicine? Does it kill an episodic cycle or just give a few hours or days of relief? Has it been tried on chronics? What meds are ok to take while receiving this treatment? How many CH sufferers have been studied? Any supportive evidence? Is it administered as a series of three, like a nerve or epidural block? How long does it paralyze the injection sites? Will it get into the trigeminal nerve? Every other day, I listen to women speak of Botox parties and which plastic surgeon is working on whose boobs or face. This Botox is nothing new in Las Vegas that's for sure, but as for CH's, there seems to be so many unanswered questions. If somebody could answer these questions, i'd probably try it and get rid of some wrinkles at the same time.
Gregg in Las Vegas

Title: Re: Botox--report on use/effectiveness
Post by hdbngr on Oct 30^th, 2003, 10:56am

Gregg:

I tried it three years ago. I had to find a plastic surgeon to do it, as he was the only one he did the injections in town. He was a migraine sufferer who injects himself, so he was willing to try it on me (chronic CH).

I got three shots in the forehead, three in the back of the head/neck. You get one vial of Botox serum, which must be kept refrigerated and has a very limited shelf life. Injections were $150 (out of pocket) and the serum was $350 (insurance paid for this after a note from my Doc) He would not inject directly in the Trigeminal nerve since he was a plastic surgeon, not a neurologist.

The shots take about 5 minutes and aren't really that painful. Like a bee sting. The results (if any) occur almost immediately, but only last three months before it wears off. Then they have to be redone. I didn't have to make any changes in medication, there was no chance of interaction. The remaining Botox was discarded, since it wouldn't have kept three months.

It didn't help the head pain much (just some of the daily low pain, not a big hit), but it did help the accompanying neck pain. Also, all of the worry lines in my forehead completely smoothed out, so that was nice. They're back now, though. It's relatively non-invasive, so I'm glad I tried it.

Title: Re: Botox--report on use/effectiveness
Post by LasVegas on Oct 30^th, 2003, 10:58am

"worth a shot", good pun.
Gregg in Las Vegas