BOTOX: Effective for Migraine in Adolescents and Children?

Results from a small randomized trial suggest that botulinum toxin injections may be an effective alternative therapy for migraine headache in children and teens that is refractory to standard treatment approaches. Currently, botulinum toxin is FDA approved for treating migraine in adults only, and few treatment alternatives exist for managing the condition in younger patients. At present the only preventative medication approved for adolescent migraine is topiramate. Lead author Shalini Shah, MD, chief of the division of pain medicine, University of California, Irvine, commented, “When children and teens have migraine pain, it can severely affect their lives and ability to function. They miss school, their grades suffer and they are left behind, often unable to reach their full potential. Clearly there is a need for an alternative treatment for those who haven’t found relief.” The findings were presented at the ANESTHESIOLOGY® 2017 annual meeting.

In advocating for a therapeutic alternative, Dr. Shah observed “Many current migraine medications have side effects including sedation, dry mouth, and confusion, which aren’t well-tolerated in children and teens.” The trial included 9 children and teens aged 8 to 17 years for whom other medications and therapies for their migraine were largely ineffective. Subjects received botulinum toxin injections every 12 weeks and were evaluated for 5 years. Incidence of migraine decreased from 8 to 29.5 days per month pretreatment to 2 to 10 days per month following treatment. Additionally, the patients’ migraine duration and intensity were significantly diminished. Dr. Shah stated that her team is currently enrolling patients in a larger randomized double-blinded trial to compare botulinum therapy to placebo.

Read a news story about the findings, with a link to more information on the trial results.

 

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