• Journal of neurology · Apr 2001

    Review

    Evidence-based medicine: botulinum toxin A in migraine and tension-type headache.

    • H Göbel, A Heinze, K Heinze-Kuhn, and W H Jost.
    • Kiel Pain Clinic, Heikendorfer Weg 9-27 D-24149 Kiel, Germany.
    • J. Neurol. 2001 Apr 1; 248 Suppl 1: 34-8.

    AbstractThe therapeutic effect of botulinum toxin in headache was observed coincidentally. The rationale for this new indication initially met with a great deal of scepticism, because the toxin's mechanism of action, cholinergic chemodenervation, does not fit the pathophysiological concept of migraine and other forms of headache. Meanwhile a fair number of studies have been published which indicate efficacy for botulinum toxin and recommend its use for the treatment of tension headache and migraine. According to the evidence-based medicine criteria, grade I evidence has been demonstrated. In addition the use of botulinum toxin for cluster-headache and secondary headache is discussed. Further large scale studies will be regarded to demonstrate the long-term efficacy.

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