The effect of abobotulinum toxin A in the prophylactic treatment of refractory migraine

Abstract

Objective: Some patients with migraine headache still experience severe migraine attacks despite use of proper prophylactic treatments. There are several treatments for refractory migraine (RM), one of which is abobotulinum toxin A (Dysport). This study aimed to investigate the efficacy of abobotulinum toxin A in the prophylactic treatment of RM. Materials and Methods: In this prospective single-arm clinical trial, 18 patients with RM were included. Patients completed a questionnaire including migraine characteristics one month before the study. Each patient received an injection of 150 U abobotulinum toxin A in the specific head and neck regions. Before and 3 months after treatment, migraine severity was evaluated. Results: The average number of attacks per month before injection was 7.56±4.06, which decreased to 1.89±1.32 3 months after injection (p<0.0001). The average duration of attacks also decreased significantly after 3 months of injection (from 20.33 hrs to 2.56 hrs per month) (p=0.0001). Three patients (16.6%) had no attacks during the follow-up period. Eleven patients (61.1%) reported mild attacks and four patients (22.2%) reported moderate pain. Conclusion: Abobotulinum toxin A (Dysport) can reduce frequency, duration, and severity of migraine attacks in patients with RM and it can be used as a prophylactic treatment in this group of patients.

Keywords

• Refractory migraine
• Abobotulinumtoxin A
• headache