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Botulinum toxin therapy of migraine and tension-type headache: comparing different botulinum toxin preparations
W J Schulte-Mattler1, J C Martinez-Castrillo
1Department of Neurology, University of Regensburg, Regensburg, Germany. wilhelm.schulte-mattler@klinik.uni-regensburg.de
Abstract:
Most of the initial reports on botulinum toxin in tension-type headache (TTH) and in migraine were positive. Unfortunately, these results were not reproduced in well-designed, randomized controlled trials. So far, doses from 20 U (Botox) to 500 U (Dysport) have been studied in patients with chronic TTH, and doses from 16 to 200 U (Botox) in patients with migraine. Overall, there is no evidence for a beneficial effect of botulinum toxin, although trends favoring botulinum toxin were reported. Experience with botulinum toxin type B (Myobloc/NeuroBloc) is limited and similar to the experience with the type A. Thus, a widespread use of botulinum toxin therapy in headache can currently not be recommended.
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