Efficacy of Botox injection around scalp nerves as prophylaxis for chronic daily headache

الملخص EN

This study aimed to assess the efficacy and safety of low doses of botulinum toxin type A (BoNT-A) for the prophylaxis of headache in patients with chronic daily headache(CDH) in a new mapping of infiltration.

This is a prospective controlled 6 months study for 112 patients with CDH comparing between two groups of patients.

Group I, 65 patients treated with medication (classic method) and Group II, 47 patients treated by BoNTA.

Patients monthly recorded for day occurrence, frequency, severity and associated headache symptoms.

During the 6-month study period, there was a statistical significant decrease in the mean change from baseline for the frequency, number and severity of headaches for BoNT-A group as compared with classical one.

In the classical group, frequency decreased from 11.57 to 8.94 (22 % reduction) while in BoNT-A the frequency decreased from 12.19 to 3.85 (68 % reduction) P =.001.

Regarding mean number of headaches per month, classical group from 21.25 to 11.23 (47 % reduction); BoNT-A: from 22.11 to 5.91 (73 % reduction); P=.001.

Mean headache severity in the BoNT-A group: no pain 24 (51.1 %), mild 22 (46.8 %), moderate 1 (2.1 %) and no one severe pain as compare with classical method no pain 22 (33.8%), mild 29 (44.6 %), moderate 13 (20.0 %) and one case severe pain (1.5 %) P = .021.

Except for sensitivity to light, sound other associated symptom nausea, vomiting and headache with physical activity there was statistical significant decrease in the BoNT-A as compared to classical group P = .042, .032 and .021 respectively.

In conclusion, small doses of the BoNT-A without using other prophylactic medications is an effective and well-tolerated prophylactic treatment in patients with CDH.