Botulinum Toxin Type A for Refractory Cluster Headache

Introduction: Botulinum Toxin Type A has shown some promise for the treatment of migraine. At times, therapies that have proven helpful for migraine are also useful for Cluster headache as well. We evaluated this therapy in 5 patients. Material and methods: There were 5 females, ages 44 to 67.All patients had chronic cluster headache, and had been refractory to the usual preventive medications. The patients kept a headache diary. Twelve injections, ten points in region anterior and two in posterior areas, 50 UI and 150 UI (equivalent doses of TBA used in our country). Results: In 3 patients, the frequency and intensity of the attacks were decreased by 50% and in another patient by 70%. Only 1 patient did not respond to TBA. There were no adverse events reported by the patients. Comments: TBA is a promising therapy for headaches, and some benefit may also be expected for cluster headache. It is possible that larger doses may prove more effective. Conclusions: There are a number of unanswered questions about the use of TBA in headache regarding the optimal sites and the effective dose. Further studies are needed in order to determine the role of Botulinum toxin for headache patients.

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