An open-label study and 2 double-blind, placebo-controlled studies have pro
vided supporting evidence of botulinum toxin type A (BTX-A) as an effective
, well-tolerated treatment for migraine. Observed durations of benefit were
consistent with known properties of BTX-A, Findings suggest that response
may vary by features of preinjection headaches, such as migraine frequency.
The precise mechanism by which BTX-A provides pain relief is hypothesized
to be related not only to acetylcholine inhibition but also to a blocking a
ction on the parasympathetic nervous system. Additional studies that contro
l factors likely to be related to response may lead to better understanding
of the BTX-A effect on migraine and an optimal treatment protocol. Copyrig
ht (C) 2001 by W,B. Saunders Company.