Botulinum toxin injections for chronic intractable headaches

  Headache is a common clinical condition and is often classified into migraine, tension-type headache and cluster headache based on clinical symptoms such as location, nature and duration of headache. Depending on the type of headache, the treatment is also different. For example, migraine is firstly treated with tretinoin, prevention with calcium antagonists, insulin and antiepileptic drugs; while cluster headache is mainly treated with lithium, prednisone and tretinoin; while tension headache is mainly treated with antidepressants. Therefore, correct diagnosis is important. However, some patients without timely and effective treatment or standardized treatment may still be transformed into chronic headache.  Chronic daily headache refers to frequent headache attacks for more than 15 days per month, with headache lasting more than 4 hours per day. There are two types of chronic headache: primary and secondary. Primary headache refers to headache that lasts for more than 15 days a month without organic or systemic diseases.  The current treatment for chronic headache is based on herbal medicine, non-steroidal anti-inflammatory drugs and anti-anxiety depressants.  The latest guidelines and evidence suggest that Botox injections are a good option. Its advantages are easy injection, good effect, safe without side effects, etc. The current evidence carried out in our department proves that about 70-80% of patients have good results.