Strategies for Improving the Efficacy of Treatment of Chronic Migraine

Objective – to assess the efficacy of botulinum toxin type A (Lantox) in the treatment of chronic migraine. Materials and methods. A total of 22 patients with chronic migraine were investigated before treatment and at four and 12 weeks after administration of 150 IU of Lantox into the muscles of the head and neck using the “follow the pain” method. Drug was administered into the corrugator, procerus, frontalis, temporalis, and occipitalis muscles. Clinical neurological investigations were carried out; the emotional domain was evaluated, with assessment of anxiety and depression, activities of daily living, and quality of life; patients completed a questionnaire on the subjective satisfaction with treatment. Results and conclusions. Treatment was found to have a significant effect on the frequency of headache attacks, which is important in the conversion of chronic headache into episodic headache. Compliance barriers were overcome by addressing psychological problems, especially depression. Use of a drug with virtually no side effects and rapid responses increased patients’ confidence in the treatment.