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Botulinum toxin A (Botox) is very effective for the temporary reduction of dynamic lines and hyperhidrosis. Although Botox is moderately effective for reducing migraine and tension headaches, its use has also been associated with occasional, brief, mild headaches. After a patient who received a 10 U injection of Botox into the glabella developed a severe, intractable headache lasting 4 weeks, these investigators undertook a prospective study of this reaction. All patients treated with Botox over a 2-month period by 3 dermatologists in a group practice were followed for signs of headache after treatment.
Of 324 patients, 4 developed severe, intractable headaches starting within 24 hours after treatment and lasting from 8 days to 4 weeks. Oral…