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04/02/2011 10:40 AM

Botox Study for ON

cmiller
cmiller  
Posts: 863
Member
I'm an Advocate

Hi Everyone,

Just wanted to repost this study about botox for ON

http://www.ncbi.nlm.nih.gov/pubmed/19076646

Headache. 2008 Nov-Dec;48(10):1476-81.

Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study.

Taylor M, Silva S, Cottrell C.

OrthoNeuro-Neurology, New Albany, OH, USA.

Abstract

OBJECTIVE: To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia.

BACKGROUND: Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain.

METHODS: Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values.

RESULTS: The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated.

CONCLUSIONS: Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain.

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04/02/2011 11:04 AM
vbiker
vbiker  
Posts: 83
Member

Thank you for posting this study. The botox injections were just becoming vogue when I was first diagnosed, but my neuro was skeptical of the benefits. And then there were those reported deaths linked to it so I never went forward with them.

Would anyone mind sharing their experiences with botox? All I've had are nerve blocks to compare to. That was 6 days pain free followed by a few days of hell as my ON made up for lost time. Does botox have a similar kick back effect?

Thank you for your comments since it looks like I may be undergoing this next.


04/02/2011 12:44 PM
theorchidthief
theorchidthiefPosts: 87
Member

I had botox for my ON about a year ago (this was when I ONLY had ON on my right side). He put in a TON of botox all over my right side of head, starting at the back right Occipital nerve and following its course and then in my temple and above my eye. He also did the left above eye so I would not have one droopy eye.

Results - NONE as far as pain relief. It also takes weeks to kick in...maybe 2? When it finally did I felt frozen in my forehead but no pain relief. And no wrinkle relief. Sad I actually looked online and some people can be resistant to Botox, though.


04/02/2011 06:44 PM
Doodleluvr
Doodleluvr  
Posts: 45
Member

I've had Botox several times by both Neurologists & Plastic Surgeons. I had no relief from the Neuros who seemed to just give tiny amounts all over the place. I definitely got relief from the Plastics, especially most recently from my ON surgeon, Dr Peled. It can take up to two weeks to feel relief but was definitely worth it.

04/02/2011 08:50 PM
bobswifeamy
bobswifeamy  
Posts: 181
Member

About 5 yrs ago I had Botox. Was not covered by ins (Even though my neuro submitted all my md history, etc) so my neuro injected me for free. He wrote me a Rx for the Botox and we bought it @ the pharmacy. It was $800 a bottle. The shots were not painful. I received them around the forehead, temples, hairline and some in the back of the head. He said it would be about 10 days before it would, however, I did not notice any difference until about one month post injections. For the next 6 weeks or so I had some relief, however the Dr thought it was coincidence, because it was so long after the shots before I felt better. My current neuro (diff dr), though says she thinks it was the Botox that helped me, that it can be that long before results are experienced. We tried it again, 4 months later, and it had no effect. The nerve blocks, although terribly painful, for me had a much better effect.

04/03/2011 04:31 AM
Arlet
ArletPosts: 165
Member

I had the standard 31 injections all around the head and neck at the beginning of March. I felt great for a week and a half afterward (Dr. Blake said it would take a couple of days for the Botox to work, so I understand that at least the beginning of my good streak was not from the Botox, but I can't help but think that the Botox extended it, as I haven't felt that well for so long in years.) I've had headaches almost every day for the past few weeks, though, so I don't know if the effects of the Botox can wear off the same way that the nerve blocks do even though the Botox stays in your system for about three months.

04/04/2011 08:32 AM
brugette
brugette  
Posts: 941
Senior Member

Thanks for the info all, I actually have 2 bottles of botox sitting at a neur/pain mgmt. docs office right now waiting for me to use. I know that Trixi did get relief, albeit temporary, from the Botox and that started me on my path to using it. However, I was not able to get it done before my daughter's wedding and am now contemplating if I really want to do this.

I'm lucky in that my insurance is coving all but $200 for it (I guess) but it still scares me for some reason. Knowing more of you have tried it is giving me the nudge I need to go ahead and try it.

Hugs,

Patty


04/04/2011 11:41 AM
Arlet
ArletPosts: 165
Member

Dr. Perry said today that getting very temporary relief with the Botox was normal, though we didn't have a very in-depth discussion about it.

04/04/2011 02:18 PM
brugette
brugette  
Posts: 941
Senior Member

Heather, thanks for the info, now I feel nudged in the "no go" direction. Seems like it may not be worth the trouble and pain of getting the injections for short term relief.

Thanks again for the info and take care.

Hugs,

Patty


04/04/2011 03:37 PM
Arlet
ArletPosts: 165
Member

I think you should try it. The actual injections really weren't that bad. Overall, I think getting the Botox was easier/less painful than doing nerve blocks. You'll never know if it works for you until you try.
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