Will Botox Help My Migraines?
Q: I wanted to get some information as far as migraines and Botox. I have suffered with migraines for many, many years and have read that Botox can help. My headaches usually start around the eyebrow area. Thank you.
A: The fact that your migraines have a focal area of initiation at the eyebrows strongly suggests that their origin is compression of the supraobital/supratrochlear nerves. Contraction of these muscles squeezes the nerves that they surround and causes a painfuol migraine to start. Botox has a good chance of having a positive effect since it weakens the muscles around those nerves as they exit from the brow bone. This is a simple treatment that looks like it may work well for you. For a few hundred dollars, you can easily prove this migraine theory. While the effect of Botox is not permanent, many responsive patients find it to be a temporary miracle that provides a level of relief that no other medication does. In select migraine patients, plastic surgeons have learned many years ago that Botox around the brow area reliefs headaches. The key to whether Botox will be a successful migraine treatment is to have a very specific point of headache origin at one of the major cranial sensory exit sites from the skull. Botox is not effective for many types of migraines, just ones that have a very specific focus or loci.
If Botox is effective, that would mean that endoscopic supraorbital/supratrochlear nerve decompression may provide some long-term reduction in your migraine symptoms.
Dr. Barry Eppley