The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Botulinum Toxin Type A Therapy in Chronic Headache Patients

만성 두통 환자에서 Botulinum Toxin Type A 치료

  • Moon, Dong Eon (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Moon, Young Eun (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Shi Hyeon (Department of Anesthesiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, EunSung (Department of Anesthesiology, College of Medicine, The Catholic University of Korea)
  • 문동언 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 문영은 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김시현 (가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김은성 (가톨릭대학교 의과대학 마취통증의학교실)
  • Received : 2005.03.29
  • Accepted : 2005.05.16
  • Published : 2005.06.30
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Abstract

Background: Chronic headache (CH) constitutes a significant public health problem, impacting on both the individual sufferer and society. Patients with CH, unresponsive to drug therapy or nerve block, suffer considerable disability due to the frequency and severity of attacks; therefore, they should be considered for novel therapy. Botulinum toxin type A (BoNT-A) has shown significant promise in the management of CH. In this paper, we review recent evidence on the efficacy of BoNT-A, and also report our experience with this treatment in CH patients. Methods: BoNT-A was used to treat 69 CH patients, including 47 in a chronic migraine group and 22 in a non-migraine CH group, who showed therapy-resistance to palliative drug or nerve block. We investigated the demography, dosage and site of BoNT-A injection, and used a visual analogue scale (VAS) for pain and the degree of satisfaction. The data were analyzed using t-tests and a Friedman repeated measures analysis of variance on ranks. Results: Significant decreases in the VAS for pain were found in both the chronic migraine and non-migraine CH groups, from 2, 4 and 12 weeks and from 4 and 12 weeks, respectively, after BoNT-A administration (P < 0.05). The chronic migraine group showed significantly lower VAS scores for pain than the non-migraine CH group from 2, 4 and 12 weeks after the BoNT-A administration (P < 0.05). Twenty eight patients (59.2%) in the chronic migraine group and eight (36.4%) in the non-migraine CH were satisfied with the BoNT-A treatment. Conclusions: This clinical study revealed that the use of BoNT-A demonstrated efficacy for CH patients resistant to drug therapy or nerve block. Moreover, BoNT-A proved itself more effective in the chronic migraine than non-migraine CH group.

Keywords

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