A blinded study comparing Botox with Topamax for the prevention of migraine headaches was conducted by Drs. Jaffri and Mathew and published in the current issue of Headache. They enrolled 60 patients and divided them into two groups – one group received real Botox and placebo tablets, while the second group received saline water injections instead of Botox, but were given tablets of Topamax. At the end of 9 months and after 2 Botox treatments the efficacy of these two treatments was the same, but many more patients in the Topamax group developed side effects and dropped out of the study.
Read MoreNovember, 2009 Monthly archive
Headache Relief is a new iPhone app which I developed to help patients better manage their headaches. The main feature of the app is a headache diary. A summary of all your diary entries can be emailed to yourself or your doctor in an Excel spreadsheet form. I find that patients who keep a diary benefit from it in many ways. The diary makes it easier to figure out what may be causing your headaches, how well the treatment works, and allows you to better control your headaches. The potential triggers that are recorded in the diary include stress, menstrual cycle, food, sleep, and other. Weather can be a major contributor and the three most common weather-related triggers are temperature, humidity and barometric pressure. A unique (and very neat) feature of this app is that if you to enter your zip code these three weather parameters will be downloaded into your diary. The app also contains an e-book with a wealth of information on headaches, natural and pharmacological therapies. And the price is right – it’s free. Please let me know what you think or better still, post your evaluations on the iTunes store.
Read MoreBotox appears to be effective for peripheral nerve pain according to a study by French researchers. This finding is consistent with my observation that injecting Botox into the skin of the top of the head in patients with headaches relieves pain in that area. When I started injecting botulinum toxin (Botox) for headaches about 15 years ago the assumption was that Botox works by relieving spasm of muscles in the forehead, temples, back of the head, and neck. However, some patients would come back and report that their headache was gone in the injected areas, but not on the top of the head. When gave additional injections the top of the head pain also stopped. I also see patients who get Botox injections for their headaches from dermatologists or plastic surgeons and do not obtain adequate relief. This is usually because only the front of the head is injected, rather then all areas of pain. There have been other reports of Botox relieving pain of diabetic as well as trigeminal neuralgia, however the French group conducted a very rigorous double-blind study which provides scientific proof of pain-relieving properties of Botox.
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