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Botulinum toxin A is approved for prophylactic treatment of chronic migraine (≥15 headaches per month). The recommended regimen — 31 injections at specified sites in head and neck muscles — may be repeated at 12-week intervals. In a meta-analysis, researchers examined the effectiveness of botulinum toxin A prophylaxis for headaches.
Findings include the following:
In five studies of chronic migraine (1508 patients; mean, 19.5 headaches monthly), botulinum toxin A significantly reduced the average number of headaches by 2.3 per month compared to placebo; the average monthly reduction in headaches was roughly 8 with botulinum and 6 with placebo.
In seven studies of chronic tension headache (675 patients, mean, 25.2 headaches monthly), botulinum …