Q: I am interested in exploring the option of using Botox to help with my migraines. I have had them since I was a teenager and am now on Topomax twice a day and rotate with Treximet, Imitrex, and Maxalt. I am 42 now. Is there any chance insurance would pay to try this?
A: Botox can be quite effective in the relief of migraine headaches, provided it is the right type of migraine. Specifically, one must have a migraine history and head and neck location that can be specifically linked to one of the peripheral triggers. This means that where it starts can be pointed to exactly one of these sites. This includes the occipital region (base of the skull), temporal region (side of the head), supraorbital (brow) and the septal (nose region) If you can specifically point your finger on the origin and location, then a Botox injection into the trigger area can serve both as a treatment and a surgical predictor. If you get good relief with Botox, then you can continue with these injections every 4 months or so as an effective treatment. Or one can go on to surgical decompression of these sites, of which three are directly related to sensory cranial nerves.
While Botox is FDA-approved for the treatment of migraines, my Indianapolis plastic surgery practice does not process insurance for these treatments. The typical cost would be around $300 to $350 for two or three injections sites.
Dr. Barry Eppley