Information on botulinum toxin for migraine
Botulinum toxin type A is one of the licensed preventive treatment options for adults with chronic migraine (headache on 15 or more days a month, with migraine features on at least 8 of them). Small doses are injected at defined points on the head, forehead, temples, back of the neck and shoulders. It is a different protocol from cosmetic botulinum toxin treatment.
Treatment details
Duration: About 15–20 minutes.
Who it is for: Adults diagnosed with chronic migraine after a neurological assessment, for whom preventive treatment options have been considered.
Number of sessions: Usually every 12 weeks; response is mostly assessed after 2–3 treatments. The final plan is set by the physician after the examination.
Diagnosis first
Treatment is considered in patients whose headache has been diagnosed as migraine through neurological assessment, after other causes such as medication-overuse headache have been excluded. New, changing or neurologically accompanied headaches first require neurological investigation.
Evidence and expectations
Meta-analyses of real-world data and guidelines report a reduction in headache days in chronic migraine. Not everyone responds; it does not cure migraine.
Possible risks
Injection-site pain, neck pain or stiffness, a temporary increase in headache, and drooping of the eyebrow or eyelid may occur. Widespread muscle weakness or difficulty swallowing or breathing requires urgent assessment.
Who may not be suitable?
Neuromuscular disease, infection at the injection site, pregnancy and breastfeeding, allergy to product ingredients and use of interacting medicines are assessed separately.
Frequently asked questions
Is botulinum toxin for migraine the same as cosmetic botulinum toxin?
The same drug group is used, but injection points, doses and purpose differ.
Is it used for every headache?
No. It is considered for adults diagnosed with chronic migraine.
When is the effect clear?
Response is usually assessed after several treatments, using a headache diary.
This text is for general information only and is not a personal diagnosis or treatment recommendation. Suitability is decided after a medical history and examination. Results vary from person to person; no particular result can be guaranteed.
References
- Lanteri-Minet M, et al. Real-world effectiveness of onabotulinumtoxinA for chronic migraine prevention: a meta-analysis of ten years of data. Cephalalgia. 2022. PMID: 36081276.
- Medrea I, et al. Canadian Headache Society guideline for the prevention of migraine (update). Can J Neurol Sci. 2024. PMID: 39506371.
