Botox injections alleviate migraine pain in children, adolescents

Shalini Shah

Children and adolescents who experience migraine headaches but do not respond to traditional treatment may benefit from injections of botulinum toxin, according to study findings presented at the Anesthesiology 2017 annual meeting.

“When children and teens have migraine pain, it can severely affect their lives and ability to function,” Shalini Shah, MD, chief of the division of pain medicine at the University of California, Irvine, said in the press release. “They miss school, their grades suffer, and they are left behind, often unable to reach their full potential. Clearly there is a need for an alternative treatment for those who haven’t found relief.”

Although Botox (onabotulinumtoxinA, Allergan) is approved by the FDA to treat migraines in adults, there are few FDA-approved medications for school-aged children and teenagers, leaving many without treatment options for migraine headaches. Researchers assessed changes in pain intensity, frequency and duration of benefit from onabotulinumtoxinA treatment in nine pediatric patients aged 8 to 17 years who experienced migraines 8 to 29.5 days per month over a 5-year period. Each patient received onabotulinumtoxinA injections in the front and back of the head and neck every 12 weeks.

Analysis showed that a statistically significant change occurred in migraine intensity, frequency and duration of migraine after pediatric patients received onabotulinumtoxinA injections. Patients experienced migraines only 2 to 10 days per month after treatment with the drug and, when they did have migraines, their headaches did not last as long, according to the press release. Patients’ migraines lasted 30 minutes to 24 hours before therapy compared with 15 minutes to 7 hours after therapy. Using a scale of 1 to 10 to indicate pain, patients’ reports ranged from 4 to 8 before treatment compared with 1.75 to 5 after treatment. None of the patients reported severe adverse events.

“After treatment, we saw improvement in functional aspects in all of the children and teens,” Shah said in the release. “Many current migraine medications have side effects including sedation, dry mouth and confusion, which aren’t well-tolerated in children and teens. Our research of Botox is part of an effort to find better treatments for children and teens with migraines, so they can realize their full potential.”

Shah and colleagues are currently enrolling patients to compare Botox to placebo in a prospective, randomized double-blinded trial. – by Savannah Demko

Reference:

Calderon MD, et al. Abstract A3082. Presented at: Anesthesiology Annual Meeting; October 21-25, 2017; Boston, MA.

Disclosures: The author reports no relevant financial disclosures.