The protocol for use of Botox-A injection therapy for treating chronic migraine is based upon the clinical research studies and guidelines are provided by the FDA. Each treatment involves 31 injections (5 Botox-A units per injection, for a total of 155 units). Areas injected include the bridge of the nose, the forehead, the temples, the back of the head, the neck, and the upper back (just above the shoulder blades).
A very small needle is used to perform the injections, which is not especially painful. Botox mixed with saline (salt water) can produce a brief burning sensation at the injection site. When treatment is performed by an experienced injector, the entire process requires no more than 10-15 minutes and is typically well tolerated. Our medical doctor performs all Botox Injections at both clinics in Simi Valley (woodranch) and Northridge.
Botox usually takes 7-12 days for it to work. A number of patients who fail to experience any improvement following their first Botox-A treatment may respond quite well when treatment is repeated. There are other Botulinum toxin that can relieve the pain sooner than Botox. If you have become resistant to Botox effects, you might want to consider Dysport or Xeomin. At NewSkin Laser Center, we offer all three Botulinum toxins and consultations with the doctor is very important in choosing the appropriate medications for your needs.
Injection of Botox into the muscles of the neck and upper shoulders causes temporary partial weakness in those muscles. Once the muscles are realaxed, people tend to experience less pain and decrease the amount of drugs used to relieve the pain. Regardless, the Botox-related weakness and the pain/stiffness resolve within days to weeks, and in the interim, symptomatic treatment with an anti-inflammatory drug may be quite effective for the pain. Muscle relaxants are to be avoided, as they may worsen the problem (muscle weakness) that precipitated the pain in the first place. Less common side effects include a temporary drooping of the eyelid, and rarely, flu-like symptoms (diffuse muscle aches, fever, a general feeling of illness); the risk of the former may be reduced by your physician using optimal injection technique, and the latter is self-limited, typically lasting only a few days at most and unlikely to recur with future injection treatments. When eyelid droop does occur, the side effect reverses within weeks.
The studies and the FDA guidelines have approved use of Botox-A injections every 3 months, with a total of 5 treatments over 15 months. Most PPOs and Medicare allow treating of chronic migraine with Botox. 3-month between injections remains the standard of care and approved by the FDA. In clinical practice, it appears that some patients receiving Botox-A will improve to the point where injection therapy may be discontinued without relapse to chronic migraine.
Immediately after the treatment, the vast majority of patients are able to return to their routine daily activities.
On average, close to 100 units of Botox is injected for Migraine Headaches. We have special pricing on large amount of units used for Botox. Majority of insurance cover this treatment including PPOs and Medicare. Please Do Not Hesitate To ask about your coverage. We will obtaine pre-authorizations from your insurance.
Yes. No single drug can treat all of the migraine sign and symptoms. Synergistic approch where multiple drugs are used is best to treat migraines. This will prevent you from overusing a single drug and rebound effect of certain drugs. Botox will help you to achieve a remission of your chronic migraine. Aggressive treatment of acute migraine headache with appropriate medications used in an appropriate fashion and at a frequency that will not cause medication overuse (“rebound”) headache will assist Botox-A in the effort to achieve a remission of your chronic migraine back to the episodic form of that headache disorder. As for oral medications intended for migraine prevention, many clinicians have found them to be complementary to Botox-A in suppressing chronic migraine, and there is no convincing evidence that use of medications intended for migraine prevention will block the positive effect of Botox-A.
Treating Migraine with Botox will need significantly more Botox units. Therefore, NewSkin Laser Center is offering Botox at lower cost for those who need more than 100 units. We have specials on 100 units or more. You may pre-purchase that as well. If you do have insurance, most insurance carriers (including Medicare) now “cover” the treatment, and you will be liable only for a co-pay, which will amount to a small fraction of the nonadjusted charge. Be aware that virtually all private insurers (PPO) require pre-authorization; to receive Botox-A injection therapy without pre-authorization could result in your being held responsible for the entire charge.
Again, treatment is performed by Dr. Darush, NewSkin Laser Center, who is skilled and experienced injector, the procedure should require no more than 10-15 minutes and can be performed in a standard examination room. Afterward, you should be able to immediately resume your routine activities. The Botox-A injections over your forehead will raise small “bumps,” but these will vanish spontaneously within hours and more quickly so if you apply ice to the region. With relative infrequency, the injection procedure may precipitate a headache that can vary in intensity from mild to severe. Conversely, do not expect Botox-A injection therapy to be effective for acutely treating any headache you may have at the time of treatment; as indicated under question number 3, and especially with the initial set of injections, the therapeutic response to Botox may be delayed for up to 2 weeks.
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