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Evidence-based medicine: botulinum toxin A in migraine and tension-type headache

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Abstract

The therapeutic effect of botulinum toxin in headache was observed coincidentally. The rationale for this new indication initially met with a great deal of scepticism, because the toxin's mechanism of action, cholinergic chemodenervation, does not fit the pathophysiological concept of migraine and other forms of headache. Meanwhile a fair number of studies have been published which indicate efficacy for botulinum toxin and recommend its use for the treatment of tension headache and migraine. According to the evidence-based medicine criteria, grade I evidence has been demonstrated. In addition the use of botulinum toxin for cluster-headache and secondary headache is discussed.

Further large scale studies will be regarded to demonstrate the long-term efficacy.

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Authors and Affiliations

  1. Kiel Pain Clinic, Heikendorfer Weg 9–27, D–24 149 Kiel, Germany, Tel.: +49-431-20099-65, Fax: +49-431-20099-50, e-mail: kiel@Schmerzklinik.de, , , , , , DE

    H. Göbel, A. Heinze & K. Heinze-Kuhn

  2. Department of Neurology and Clinical Neurophysiology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191 Wiesbaden, Germany, , , , , , DE

    W. H. Jost

Authors
  1. H. Göbel
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  2. A. Heinze
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  3. K. Heinze-Kuhn
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  4. W. H. Jost
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Göbel, H., Heinze, A., Heinze-Kuhn, K. et al. Evidence-based medicine: botulinum toxin A in migraine and tension-type headache. J Neurol 248 (Suppl 1), I34–I38 (2001). https://doi.org/10.1007/PL00007818

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  • DOI: https://doi.org/10.1007/PL00007818

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