Botulinum Toxin Infiltrations for Chronic Migraine Are Efficacious and Safe: the Bruges Experience

Event Abstract Back to Event Botulinum toxin infiltrations for chronic migraine are efficacious and safe: the Bruges experience Bruno A. Bergmans1*, Rose Bruffaerts2, 3, Marie-damienne Verhalle4, Kristof Verhoeven1, Annelies Van Dycke1 and Olivier Deryck1 1 AZ St-Jan Brugge-Oostende AV, Campus Brugge, Neurology Department, Belgium 2 UZ Leuven, Neurology Department, Belgium 3 University of Leuven, Laboratory for Cognitive Neurology, Belgium 4 AZ St-Jan Brugge-Oostende AV, Campus Henri Serruys, Neurology Department, Belgium Introduction Since the PREEMPT trials botulinum toxin infiltrations have become mainstay treatments for chronic migraine. Although not reimbursed in Belgium, botulinum toxin infiltrations can be a viable option for refractory chronic migraine patients in whom previous oral treatments have failed. Methods Patients meeting criteria for chronic migraine who had failed conventional oral treatments for the condition were proposed botulinum toxin infiltrations. After informed consent, they were asked to keep detailed headache calendars, documenting the number of headache days, the number of migraine days, the intensity of the headaches/migraines and analgetic use. We compared these parameters before treatment and after two cycles of botulinum toxin infiltrations. Statistical significance was calculated by means of a Wilcoxon signed rank test. Results In our preliminary cohort of 7 patients treated with botulinum toxin no major adverse events were reported. One patient reported a mild transient unilateral ptosis that did not hamper vision. On average we observed a reduction in headache days from 26.6 days/month before treatment to 22.0 days/month after treatment (p=0.250). The number of migraine days after 2 cycles was reduced on average from 15.6 to 8.2 migraine days/month (p=0.016). The average reduction of the number of days that painkillers were used after 2 treatment cycles, was much less pronounced, from 9.1 to 7.6 days/month (p=0.406). Conclusions In our experience, even though high doses of botulinum toxin are used in chronic migraine, the treatment is safe. In selected patients with refractory chronic migraine botulinum toxin infiltrations can significantly improve the headache control. We observed that there is a subpopulation of patients with a distinct and significant effect of the infiltrations who will continue treatment beyond 2 treatment cycles. Another subpopulation seems to have little or no benefit from the infiltrations and will discontinue treatment after 2 cycles. We will investigate in a regression analysis in 18 patients which patient characteristics influence the success of the botulinum toxin treatments. References 1. Diener HC, Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia. 2010 Jul;30(7):804-14. 2. Aurora SK, Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia. 2010 Jul;30(7):793-803. Keywords: chronic migraine, Botulinum Toxins, Headache, Analgesics, Infiltration Conference: Belgian Brain Council 2014 MODULATING THE BRAIN: FACTS, FICTION, FUTURE, Ghent, Belgium, 4 Oct - 4 Oct, 2014. Presentation Type: Oral Presentation Topic: Clinical Neuroscience Citation: Bergmans BA, Bruffaerts R, Verhalle M, Verhoeven K, Van Dycke A and Deryck O (2014). Botulinum toxin infiltrations for chronic migraine are efficacious and safe: the Bruges experience. Conference Abstract: Belgian Brain Council 2014 MODULATING THE BRAIN: FACTS, FICTION, FUTURE. doi: 10.3389/conf.fnhum.2014.214.00066 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 01 Jul 2014; Published Online: 13 Jul 2014. * Correspondence: Dr. Bruno A Bergmans, AZ St-Jan Brugge-Oostende AV, Campus Brugge, Neurology Department, Bruges, 8000, Belgium, bruno.bergmans@azsintjan.be Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Bruno A Bergmans Rose Bruffaerts Marie-damienne Verhalle Kristof Verhoeven Annelies Van Dycke Olivier Deryck Google Bruno A Bergmans Rose Bruffaerts Marie-damienne Verhalle Kristof Verhoeven Annelies Van Dycke Olivier Deryck Google Scholar Bruno A Bergmans Rose Bruffaerts Marie-damienne Verhalle Kristof Verhoeven Annelies Van Dycke Olivier Deryck PubMed Bruno A Bergmans Rose Bruffaerts Marie-damienne Verhalle Kristof Verhoeven Annelies Van Dycke Olivier Deryck Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.