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C A S E S T U D Y

MIGRAINE TREATMENT aestheticmed.co.uk

Head’s up

Dr Pradnya Apte explains how she used Botox injections
to bring relief to a patient suffering from severe migraines

hy toxin injections help with them to contract. When Botox
migraines is not fully understood. is injected, the release of
Sensory nerves carry pain acetylcholine is blocked,
impulses and secrete chemicals preventing the contraction of
Wsuch as CGRP (calcitonin gene the muscle. Abnormal muscle
related peptide) – a neuropeptide. Neuropeptides contraction is reduced by toxin,
are small protein-like molecules (peptides) used which allows the muscle(s) to
by neurons to communicate with each other. They become less stiff. This aspect of
are neuronal signalling molecules that influence toxin might help with neck muscle
the activity of the brain and the body in specific stiffness, which is commonly seen
ways. in patients with chronic pain such as
CGRP has been shown to be strongly implicated migraine.
in the cascade of migraine symptoms. When
botulinum toxin enters the muscle, the muscle CONSULTATION
acts as a container to keep the Botox around the Patient Hayley Smith, who is 34 and lives
sensory nerve, allowing it to be absorbed into the in Exeter with her partner and two young
nerve. Once in the nerve, it decreases the release children, had suffered for most of her adult
of CGRP and other chemicals involved in migraine. life with chronic migraines, however over
CGRP is also a vasodilator which dilates the blood the last two years these had been increasing in
vessels, and this can sustain a migraine. intensity. Sometimes a migraine could last as long
When Botox is used cosmetically, it works as two weeks for Hayley.
specifically on the muscle. For a muscle When visiting the clinic for an aesthetic
to contract, the nerve releases a chemical procedure, Hayley mentioned her fluctuating
messenger called acetylcholine. Acetylcholine migraines and I suggested that treatment
is a neurotransmitter which sends signals from with Botox could help in reducing them. I have
one neuron to another. In this case, acetylcholine treated a number of male and female patients
attaches to cells in the muscle, which causes with botulinum toxin for their migraines with

44 Aesthetic Medicine • June 2020