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Cure for heady EPISODES.

Botox is one of the new techniques for the treatment of migraines

SPLITTING headaches that make you feel sick and distort your vision steal much from your life. They wear you down, make you passive and leave you completely disoriented.

They not just lead to great suffering but also interfere with your relationships and career.

When these headaches don't ease even after years of medication and relaxation techniques many start resigning themselves to their fate.

Migraines affect about 18 to 20 per cent of the population and nowadays it's not just women who suffer from these but men too are falling prey to them. Migraine per se is not life threatening except for the reports which say that it makes sufferers susceptible to strokes. But migraine mars the quality of life due to regular episodes of painful headaches which often get triggered by environmental factors or food sensitivities or lifestyle factors.

New options in migraine treatment are successful for some. The latest is a cosmetic procedure -' brows lift' - which was carried out on a British woman to remove part of her ' frown muscle' and treated her chronic migraine headaches which she had been suffering from the past seven years. Many migraines are caused by the frown muscle which contracts and puts pressure on the surrounding nerve leading to headaches.


ANOTHER treatment for chronic migraine which has been in use for years but received approval a month back is botulinum toxin type A. After approving botulinum toxin for various medical conditions such as uncontrolled blinking, excessive sweating and neck spasms, The Food and Drug Administration approved the popular brand of botulinum toxin Botox as a treatment to prevent chronic migraines this October."Chronic migraine sufferers often don't respond to medication and keep switching doctors to get relief. In such cases botox could be effective. It reduces the frequency of headaches drastically and even enables people to respond to medication," says Dr Sumit Singh, Head, Movement Disorders & Headache, Medanta The Medicity. Dr Singh has been injecting botulinum toxin for various medical conditions for the past ten years and also founded the headache clinic at AIIMS.

Migraine is still a very poorly understood illness. However, most medical experts believe that it is a neurobiological disorder in which certain chemical substances are released which cause changes in the brain and that a person is inherently prone to the release of such chemical substances in response to environmental or food sensitivities.

Botulinum toxin works by temporarily blocking nerve signals that release such chemicals to certain muscles or glands. "Botulinum toxin is just like any other migraine medication which helps in preventing migraine attacks. It improves the severity of headaches and cuts down the frequency of headaches drastically," says Dr Singh.

Choosing an experienced practitioner to inject botulinum toxin is very important. Since very few go for botox in India, it takes years for a doctor to learn to inject the needle at the right angle, dilute the toxin in the right concentration, to use the correct dilutant, to accurately identify the muscles in the head and the face and most important ly, use the right dosage. "About 25 injections have to be given in the forehead, temples, the back of the head, the neck and shoulders, which requires great precision because these muscles are paper thin," says Dr Singh.

However, it is not a wonder drug which can eliminate headaches for ever. If this is effective, the treatment typically needs to be repeated every three or six months. And, the costs are prohibitive. Each vial of botulinum toxin costs about ` 17, 000.

Also, many patients switch over to medications after some years to which they weren't responding earlier. Also, there are a few side effects of botulinum toxin.

Many people experience irritation and pain. And if the toxin gets diffused in the surrounding muscles, the person might experience weakness in that particular muscle which can cause double vision.

FDA has approved botulinum toxin for only severe form of migraine involving headaches on at least 15 days a month. But, according to Dr Singh, it can be given to acute migraine sufferers.

" I have given botulinum toxin to people with acute migraine. And they have responded well to it.

They have had fewer and lesser severe attacks of migraine," says Dr Singh.


A RELATIVELY cheaper treatment for migraine is biofeedback, a technique that has become popular in the last two decades for the prevention and treatment of migraines. Biofeedback is a mind and body technique in which an individual becomes aware of the physiological processes in the body which has gone awry and is taught to control this. Simply put, it is a relaxation technique which teaches headache sufferers to control certain involuntary functions of the body, such as heart rate or body temperature, which can ward off headaches. " Our internal body processes which have gone aberrant are extremely resistant to change. To bring them to their normal state, the mind has to be trained," says Dr P K Jha, consultant, neurosurgeon, Dharamshila Hospital and Research Centre, who is using biofeedback therapy to help patients with various conditions.

Migraine headaches occur when blood vessels constrict and dilate leading to the release of pain causing chemicals and an activation of the sympathetic nervous system. " Through biofeedback you control the blood flow in your body and therefore control your headaches," says Dr Jha.

harsha. chawla@ mailtoday. in

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Publication:Mail Today (New Delhi, India)
Date:Dec 14, 2010
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