Botox for chronic migraine: how the protocol works and who qualifies
Équipe médicale Nuance Clinic
Migraine toxin therapy is a medical intervention with a defined protocol and defined criteria. This guide explains the difference from cosmetic treatment, who is a candidate, what the injection pattern involves, and how success is measured over two cycles.
En bref
- For chronic migraine: 15+ headache days per month.
- Standardised 31+ point protocol every 12 weeks.
- Preventive, not a treatment for an attack in progress.
- Assess success over two cycles with a headache diary.
De quoi s’agit-il
- The PREEMPT protocol distributes toxin over 31 or more points across the forehead, temples, back of the head, neck and shoulders.
- It reduces the release of pain-signalling neuropeptides and relieves muscular trigger points — it is preventive, not a rescue treatment for an attack in progress.
À qui cela s’adresse
- Chronic migraine diagnosed by frequency and pattern
- Patients whose oral preventive medication is insufficient or poorly tolerated
- Tension-type headache with a strong muscular component may also benefit
- Not suitable in pregnancy, neuromuscular disease, or when headaches have not been medically evaluated
Produits utilisés
Original licensed botulinum toxin type A, dosed according to the standard protocol
Déroulé du traitement
- Headache history, diary review and neurological screening; referral if red-flag symptoms are present.
- Standardised injection pattern across defined muscle groups.
- Session repeated at 12-week intervals.
Sécurité
- Neck dosing must respect anatomy to avoid neck weakness.
- Any new, severe or atypical headache pattern is investigated before treatment.
Avant le rendez-vous
Bring a headache diary of the last 1–3 months and a list of current medication.
Soins après le traitement
Avoid massaging the neck for 24 hours; normal activity otherwise.
Résultats et durée
- Benefit usually starts within 2–4 weeks.
- The full picture is judged after two cycles (about six months).
- Many patients report fewer headache days and lower painkiller use.
Effets indésirables et risques possibles
Neck stiffness or weakness, temporary brow heaviness, bruising, injection-site pain.
Suivi
Headache-day tracking between sessions and a structured review at each 12-week visit.
Questions sur ce traitement
Is this the same as cosmetic botox?
Same molecule, different protocol, dose and purpose. The migraine protocol covers head, neck and shoulders.
Will it stop a migraine attack?
No. It is preventive treatment that reduces how often and how severely attacks occur.
How long before I know if it works?
Two treatment cycles — roughly six months — is the accepted assessment window.
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