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Botulinum toxin (DYSPORT) in tension-type headaches.

AbstractOBJECTIVES: Botulinum toxin type A is effective in the reduction of muscle tenderness and pain in many diseases associated with myofascial pain. Since increased muscle tension may contribute to tension-type headaches, injections of botulinum toxin could be of therapeutic value. METHODS/PATIENTS: Results of own investigations are presented, in particular a double-blind, placebo-controlled study with 21 patients fulfilling the International Headache Society criteria for tension-type hedaches. Participants were randomly assigned to verum (pericranial injection of 10 x 20 MU DYSPORT) or placebo condition (injection of isotonic saline in the same manner). RESULTS: After 4, 8, and 12 weeks no significant differences between placebo and verum could be observed. Nevertheless, both groups significantly improved. DISCUSSION: The findings strongly suggest that higher doses or other injection sites might be necessary to achieve therapeutic effects of botulinum toxin in tension-type headaches. Actually, we are participating in a multi-center study using 500 MU of DYSPORT. Besides dose-finding problems, another explanation could be that peripheral mechanisms--such as increased pericranial muscle tension--only play a minor role in the pathogenesis of tension-type headaches.
AuthorsJ D Rollnik, R Dengler (Affiliation: Medical School of Hannover, Department of Neurology and Clinical Neurophysiology, Hannover, Germany.)
JournalActa neurochirurgica. Supplement (Acta Neurochir Suppl) Vol. 79 Pg. 123-6 ( 2002) ISSN: 0065-1419 [Print] Austria
PMID11974977 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Botulinum Toxin Type A
  • Neuromuscular Agents
Topics
  • Adult
  • Botulinum Toxin Type A (administration & dosage, therapeutic use)
  • Double-Blind Method
  • Electromyography
  • Humans
  • Injections
  • Middle Aged
  • Neuromuscular Agents (administration & dosage, therapeutic use)
  • Tension-Type Headache (drug therapy, physiopathology)

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