Avellanet M, Pages-Bolibar E, Boada-Pladellorens A, Grillo C, Gea E

Language: Spanish
References: 26
Page: 52-57
PDF size: 446.36 Kb.

ABSTRACT

Introduction: chronic migraine poses a significant clinical challenge due to its high prevalence, functional impact, and limited response to oral preventive therapies. Botulinum toxin type A has emerged as a validated alternative in refractory CM. The aim was to analyze the efficacy and safety of botulinum toxin in refractory chronic migraine over 15 years in a clinical cohort and review its mechanism of action and therapeutic profile. Material and methods: retrospective longitudinal cohort study of adult patients with refractory chronic migraine treated with botulinum toxin following the PREEMPT protocol (155-195 U, 31 points, every 12 weeks). Headache days/month, pain intensity, symptomatic medication use, and adverse effects were assessed. Results: 57 patients were evaluated (77.2% women), 65% achieved a ≥ 50% reduction in headache days. A significant decrease in triptan/analgesic use and good tolerance were observed, 47% continued treatment with botulinum toxin, 21% required a switch to monoclonal antibodies. Adverse effects were mild and reversible, 26.3% had associated psychiatric conditions. Conclusions: type A Botulinum toxin is effective and safe in refractory chronic migraine, providing sustained benefit and a favorable safety profile. Its integration into a multidisciplinary approach optimizes migraine management.

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