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Neuropediatrics 2022; 53(05): 344-350
DOI: 10.1055/a-1832-9168
Original Article

Is Botox Right for Me: When to Assess the Efficacy of the Botox Injection for Chronic Migraine in Pediatric Population

Ajay Goenka
1   Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
,
Sarah G. Yu
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
,
Monica C. George
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
,
Mahesh Chikkannaiah
1   Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
,
Sarah MacDonald
1   Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
,
Adrienne Stolfi
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
,
Gogi Kumar
1   Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
2   Department of Pediatrics, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, United States
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Abstract

Botulinum toxin type A (BoNT-A) has shown to be a safe and effective treatment for children with chronic migraines. Our study was to assess the efficacy of the Onabotulinum toxin type A at different intervals after initiation of therapy. We conducted a retrospective and prospective analysis of 34 patients at a children's hospital where children received four rounds of the BoNT-A therapy for the treatment of chronic migraine. Among the 34 patients, 25 patients (age range: 13–21 years), who responded to the BoNT-A therapy, were included in the analysis. Patients received standard 31 injection, 155 unit's protocol. Patients were assessed every 3 months after their initial injection. Reasons for discontinuation of therapy were analyzed. After the first two BoNT-A sessions, significant improvement was observed with a decrease in headache frequency and intensity (p < 0.001). There was further reduction in headache frequency and intensity with the fourth round of BoNT-A therapy, with comparative analysis between the second and fourth round showing a p-value of <0.001. In terms of reduction of emergency room visits and hospitalization, a significant improvement was seen after the third round of BoNT-A therapy (p < 0.01). A significant decrease in the number of abortive and preventive medications was seen after the second round of BoNT-A therapy (p < 0.001). The efficacy of BoNT-A treatment in decreasing headache frequency, intensity, and the number of abortive and preventive medications can be assessed effectively after two treatment sessions. This trend continued to be observed with additional third and fourth sessions.

Keywords

onabotulinum toxin type A - migraine - pediatrics

Author Contributions

A.G.: drafting/revising the manuscript. S.G.Y.: drafting/revising the manuscript. M.C.G.: revising the manuscript. M.C.: drafting/revising the manuscript. S.M.: revising the manuscript. A.S.: statical analysis. G.K.: drafting/revising the manuscript.




Publication History

Received: 20 October 2021

Accepted: 19 April 2022

Accepted Manuscript online:
22 April 2022

Article published online:
21 July 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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