Dr James Higgins, MBChB, MRCGP, DFRSH, DRCOG, DCH
Botox for chronic migraines
Chronic migraine can be a debilitating condition for people affected, resulting in significant symptoms often for many years, which can affect work life, as well as home life. Migraines are often described as a severe throbbing pain, which typically affects one side of the head or behind the eye. They are commonly associated with difficulties tolerating bright lights or loud noises and may be accompanied by vomiting and visual disturbances. Some people have clear triggers for migraine, whereas in other people they can occur without cause.
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Botox has been approved by the National Institute of Clinical Excellence (NICE) since 2012 as an option in management of chronic migraines. Chronic migraines are defined as headaches occurring for at least 3 months, affecting the individual on at least 15 days of each month, and where at least 8 days of those the headache is a migraine headache.
Is Botox suitable for me?
We advise that if you have a headache syndrome that has not yet been diagnosed, you should consult with your GP in the first instance to ensure that further investigation / specialist referral is not required. If it is confirmed that you are suffering with chronic migraine then you may be eligible for this treatment via GP referral to a specialist in the NHS. We do not provide any services on behalf of the NHS, so any treatment with us would require funding privately.
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Suitability for Botox would be assessed at your consultation with Dr. James. There are relatively few medical reasons that would mean you could NOT have Botox (for example if you are pregnant or breastfeeding, or if you have a history or neuromuscular conditions such as Myasthenia Gravis or Eaton-Lambert Syndrome), however there may be other more appropriate treatments that could be suggested first.
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What will happen at my appointment
Dr. James will take a full history of your headaches & medical history, and will undertake a thorough examination. Following this, an assessment will be undertaken regarding your present & past treatments. If you are felt to be suitable for Botox to help manage your migraines then discussions of the risks & benefits can take place & the procedure undertaken if desired.
Why is there a charge for the consultation?
Whereas for all our aesthetic procedures we offer a free no-obligation consultation, we are unable to offer this for a chronic migraine consultation. This is because the assessment is a more detailed medical assessment of headache, which can be substantially more time consuming. If it is agreed that Botox is appropriate in your case then the consultation fee would be taken off the subsequent cost of your treatment.
What can I expect?
If you are felt suitable for Botox for chronic migraine then this can be undertaken the same day, or at a later date as per your preference. A total of 31 injections are required across various sites of the head & neck. Improvement in migraines should be felt within 2 weeks of the treatment and can be expected to last up to 12 weeks.
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Studies assessing the effectiveness of Botox for chronic migraines have demonstrated a reduction of 7.8-9.2 headache days per month in those treated with Botox.
Any Questions?
Possible side effects
Some people experience minor bruising at the injection sites. Following the migraine protocol for injection can result in a slight drop to the brow or eyelid due to the sites & doses of recommended toxin placement. As a doctor managing both migraines & aesthetics, on discussion, the approach taken by Dr. James can be varied to achieve both migraine relief as well as a positive aesthetic benefit should you wish.