Botulinum toxin in the treatment of post-traumatic headache - case study

Pharmacotherapy of acute post-traumatic tension headaches consists of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Treatment of chronic tension-type head-aches consists mainly of tricyclic antidepressants; local injection of botulinum toxin is one of the comparatively newer therapeutic options. No data on the treatment of post-traumatic headaches with botulinum toxin exist. A 62-year-old woman with a history of major traumatic brain injury five years previously developed chronic tension-type headaches of an oppressive nature. The results of treatment with oral medication were not satisfactory. The patient was treated with local injections of 22 IU Botox® into the frontalis muscle and corrugator supercilii muscle. After only five days, the headaches had improved and after ten days the patient was free of symptoms even when under stress. Sufficiently large-scale clinical studies are now required to better evaluate the effects of botulinum toxin on post-traumatic headaches.