Botulinum toxin injections for the treatment of frontal tension headache

Kokoska, Mimi S.; Glaser, Dee Anna; Burch, Christine M.; Hollenbeak, Christopher S.

doi:10.1007/s10194-004-0077-6

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…These effects have yet to be demonstrated in humans (15). BoNTA efficacy as prophylactic treatment of TTH has been assessed in several small controlled trials, but the evidence of a treatment effect has thus far been mixed or lacking (17, 23, 25, 27, 30, 38). The reasons for the lack of efficacy of BoNTA treatment of CTTH in this trial may be related to the injection protocol, the BoNTA dosage range, the patient population or ineffectiveness in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…BoNTA modification of pain pathways may potentially inhibit the pain associated with headache disorders. The results of double‐blind, placebo‐controlled trials, open‐label trials and retrospective chart reviews show mixed evidence of efficacy that focal injections of BoNTA significantly reduce the frequency, severity and disability associated with migraine, TTH and other types of headaches (16–30). The varying results may be due to patient selection, the number of BoNTA treatments administered, the injection protocol employed or the dosage range used.…”

Section: Introductionmentioning

confidence: 99%

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Botulinum Toxin Type A in the Prophylactic Treatment of Chronic Tension-Type Headache: A Multicentre, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

et al. 2006

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We studied the safety and efficacy of 0 U, 50 U, 100 U, 150 U (five sites), 86 Usub and 100 Usub (three sites) botulinum toxin type A (BoNTA; BOTOX®; Allergan, Inc., Irvine, CA, USA) for the prophylaxis of chronic tension-type headache (CTTH). Three hundred patients (62.3± female; mean age 42.6 years) enrolled. For the primary endpoint, the mean change from baseline in the number of TTH-free days per month, there was no statistically significant difference between placebo and four BoNTA groups, but a significant difference favouring placebo vs. BoNTA 150 was observed (4.5 vs. 2.8 tension headache-free days/month; P = 0.007). All treatment groups improved at day 60. Although efficacy was not demonstrated for the primary endpoint, at day 90, more patients in three BoNTA groups had ≥50± decrease in tension headache days than did placebo ( P ≤ 0.024). Most treatment-related adverse events were mild or moderate, and transient. BoNTA was safe and well-tolerated in the study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Type A in the Prophylactic Treatment of Chronic Tension-Type Headache: A Multicentre, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

et al. 2006

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“…There have been conflicting results for treatment with the muscle relaxant tizanidine [61,67], whilst the NMDA‐antagonist memantine was not effective [68]. Botulinum toxin has been extensively studied [69–79]. It was concluded in a systematic review that botulinum toxin is likely to be ineffective or harmful for the treatment of chronic TTH [63].…”

Section: Prophylactic Drug Treatment Of Tthmentioning

confidence: 99%

EFNS guideline on the treatment of tension‐type headache – Report of an EFNS task force

Bendtsen

Evers

Linde

et al. 2010

Euro J of Neurology

353

256

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Background: Tension-type headache (TTH) is the most prevalent headache type and is causing a high degree of disability. Treatment of frequent TTH is often difficult. Objectives: To give evidence-based or expert recommendations for the different treatment procedures in TTH based on a literature search and the consensus of an expert panel. Methods: All available medical reference systems were screened for the range of clinical studies on TTH. The findings in these studies were evaluated according to the recommendations of the EFNS resulting in level A, B or C recommendations and good practice points. Recommendations: Non-drug management should always be considered although the scientific basis is limited. Information, reassurance and identification of trigger factors may be rewarding. Electromyography (EMG) biofeedback has a documented effect in TTH, whilst cognitive-behavioural therapy and relaxation training most likely are effective. Physical therapy and acupuncture may be valuable options for patients with frequent TTH, but there is no robust scientific evidence for efficacy. Simple analgesics and non-steroidal anti-inflammatory drugs are recommended for the treatment of episodic TTH. Combination analgesics containing caffeine are drugs of second choice. Triptans, muscle relaxants and opioids should not be used. It is crucial to avoid frequent and excessive use of analgesics to prevent the development of medicationoveruse headache. The tricyclic antidepressant amitriptyline is drug of first choice for the prophylactic treatment of chronic TTH. Mirtazapine and venlafaxine are drugs of second choice. The efficacy of the prophylactic drugs is often limited, and treatment may be hampered by side effects. ObjectivesThese guidelines aim to give evidence-based recommendations for the acute and prophylactic drug treatment of TTH. In addition, the guidelines aim to provide a short overview on non-drug treatment of TTH based on the best performed controlled trials, reviews and meta-analyses, whilst the vast amount of uncontrolled reports of non-drug treatment will not be considered. A brief clinical description of the headache disorders is included. The definitions follow the diagnostic criteria of the International Headache Society (IHS) [1].

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“…48,54 Botulinum toxin has been extensively studied but a systematic review concluded that it is is likely to be ineffective or harmful for the treatment of chronic TTH. 50,[55][56][57][58][59][60][61][62][63][64][65]…”

Section: Miscellaneous Agentsmentioning

confidence: 99%

An Overview of the Recent European Federation of Neurological Societies Guidelines on the Treatment of Tension-type Headache

Bendtsen¹

2011

European Neurological Review

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Tension-type headache (TTH) is the most prevalent headache type and causes a high degree of disability. This paper provides an overview of the recently published European Federation of Neurological Societies guideline on the treatment of TTH, which recommended that non-drug management should always be considered for this condition. For example: information, reassurance and identification of trigger factors may be rewarding; electromyograph biofeedback has a documented effect in TTH; cognitive-behavioural therapy and relaxation training most likely also are effective; and physical therapy and acupuncture may be valuable options for patients with frequent TTH. Simple analgesics and non-steroidal anti-inflammatory drugs are recommended for treatment of episodic TTH. Combination analgesics containing caffeine are drugs of second choice. Excessive use of analgesics should be avoided to prevent the development of medication-overuse headache. The tricyclic antidepressant amitriptyline is the first choice for prophylactic treatment of chronic TTH. Mirtazapine and venlafaxine may be used second line.

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Botulinum toxin injections for the treatment of frontal tension headache

Cited by 12 publications

References 19 publications

Botulinum Toxin Type A in the Prophylactic Treatment of Chronic Tension-Type Headache: A Multicentre, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

Botulinum Toxin Type A in the Prophylactic Treatment of Chronic Tension-Type Headache: A Multicentre, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study

EFNS guideline on the treatment of tension‐type headache – Report of an EFNS task force

An Overview of the Recent European Federation of Neurological Societies Guidelines on the Treatment of Tension-type Headache

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