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OnabotulinumtoxinA in pediatric chronic daily headache

Marielle Kabbouche1, Hope O'Brien, Andrew D Hershey

  • 1Division of Neurology, Cincinnati Children's Hospital Medical Center, Headache Center, MLC #2015, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. marielle.kabbouche@cchmc.org

Current Neurology and Neuroscience Reports
|January 26, 2012
PubMed

Insights

OnabotulinumtoxinA significantly reduced monthly headache days and disability in pediatric chronic migraine patients who failed other treatments. This finding supports its use in young individuals with difficult-to-treat headaches.

Area of Science:

  • Neurology
  • Pediatric Headache Management

Background:

  • Chronic migraine affects approximately 3% of pediatric headache cases.
  • Many pediatric chronic migraine cases are refractory to multiple preventive medications.
  • OnabotulinumtoxinA (Botox) is FDA-approved for chronic migraine in adults but has limited pediatric data.

Purpose of the Study:

  • To evaluate the effectiveness and tolerability of OnabotulinumtoxinA in a pediatric chronic migraine population.
  • To assess changes in headache frequency and disability after OnabotulinumtoxinA treatment in children and adolescents.

Main Methods:

  • Retrospective review of patients treated with OnabotulinumtoxinA for chronic migraine at a large pediatric headache center (2004-2010).
  • Inclusion criteria: pediatric patients with chronic headache failing two or more preventive medications.
  • Data analysis focused on changes in headache days per month and pediatric disability scores.

Main Results:

  • Statistically significant reduction in monthly headache days observed post-treatment.
  • A 30-point decrease in pediatric disability scores was noted between initial and follow-up injections.
  • Patient disability shifted from severe to moderate levels.

Conclusions:

  • OnabotulinumtoxinA demonstrated effectiveness in reducing headache frequency and improving disability in pediatric patients with chronic migraine.
  • The findings support the recommendation of OnabotulinumtoxinA for pediatric patients with chronic migraine refractory to standard treatments.

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