Why Did Botox Not Work For My Migraines?

Q: Dr. Eppley, I got treated with Botox for migraines three months ago and it was not effective. It was done by a neurologist and when I asked why it did not work he said he did it in the “standard FDA” way by a band formation around the head, neck and forehead.  This is so disappointing and I paid around $3,000 to have it done.

A: That is certainly disappointing to hear not only because it did not work but because of the way it was done. There is no such thing as a ‘standard FDA’ way to do it. If that statement meant that it was done by using the clinical information and methods that was the basis for what made Botox approved for migraine treatment by the FDA, the ‘wrap around the head ‘ method was not it. Botox works for a select group of migraine patients who have identifiable peripheral trigger points in the frontal, temporal and occipital regions by both examination and history. It is these very specific points which are injected not in a random method. You may benefit by Botox injections if you have these trigger points so your lack of improvement is more likely due to that you are either not a good candidate or the injection approach was flawed.

Dr. Barry Eppley

Indianapolis, Indiana