A diagnosis of chronic migraine usually means that you get headaches on 15 or more days every month for at least three months; and eight of those 15 days have migraine symptoms, including severe pain.

If you suffer from chronic migraines, you’ll know that they’re more than just a headache. The pain of migraine can be severe, and you may notice that you’re excessively sensitive to light, loud sounds or smells and may feel nauseous or vomit during an attack. Frequent migraines can have a real effect on your life and what you can do.

When you suffer from unpredictable bouts of migraine, you probably feel you’re totally alone. But you’re not. It’s estimated that about 1-2% of people worldwide suffer from chronic migraine.

Botulinum toxin type A, also known as Botox®, is a natural protein that’s made by a certain kind of bacteria. The protein is removed from the bacteria and then specially prepared before use. This protein is the “active ingredient”: in other words, it’s the part of the medicine that does the work, and it can be helpful in medical conditions such as chronic migraine.

This protein is the active ingredient – the part of the medicine that does the work – and it’s thought that Botox® helps migraines by blocking the chemicals (neurotransmitters) that carry pain signals before they reach the nerve endings. This indirectly blocks the development of a migraine.

All eligible adults over the age of 18 can access this treatment.

Starting a new course of migraine treatment is a major step. So, before recommending treatment your doctor will have checked that it is a suitable treatment for you. As a guide, you should not receive the treatment if:

• you have had a bad reaction to botulinum toxin type A treatment in the past
• you have an infection at or around any of the areas to be injected
• you are pregnant or breast feeding

There are specific qualification criteria in order to access Botox treatment for chronic migraine and these will be discussed with your doctor.

Starting a new course of Botox® for migraine treatment is a major step. So, before recommending treatment your Consultant will have checked that it’s a suitable treatment for you. As a guide, you shouldn’t have Botox for migraine treatment if:

• You’ve had a bad reaction to botulinum toxin type A treatment in the past
• You have an infection at or around any of the areas to be injected
• You’re pregnant or breastfeeding

Before you start your Botox® for headaches treatment, your Consultant will discuss what the treatment involves and what you can expect, including any side effects. Once your treatment has started, if you notice any side effects then you should tell your doctor straight away.

You should continue with your migraine diary, noting down:

• How many times you get headaches or migraines each month
• How long they last
• How severe they are

An anaesthetic is not required for your treatment.

Your treatment consists of a set of injections that you will have in the outpatient’s department of the hospital. You’ll only need to have this treatment once every 12 weeks.

Your Consultant will inject tiny amounts of botulinum toxin type A into the muscles around your head, neck and shoulders. Each session will need 31 injections and will take about 15 minutes.

If you don’t like needles, or you’re anxious or worried about your treatment, please speak to your medical team. They’ll be able to reassure you and answer any questions you may have – and tell you what we can do to help you relax during your treatment.

Please refer to the Patient Information Leaflet provided with the treatment for more information.

As with any type of injection, you may experience some discomfort during your treatment session, but this shouldn’t last for long.

Your Consultant or nurse may ask you to stay at the clinic for a short while, to check that you’re comfortable following your treatment and to arrange your next appointment, if needed.

You may get some bumps on the skin at the places where you were injected, but these should disappear within a few hours. Try not to rub the places where you have been injected for 24 hours after you receive your injections, to allow your treatment to work properly.

No. This Botox® treatment results in no change of appearance. You may get some bumps on the skin at the places where you were injected, but these should disappear within a few hours.

Like all medicines, Botox® for migraine can cause side effects, although not everybody gets them. In general, side effects occur within the first few days following the injection and last only for a short time. In rare cases, they may last for several months or longer.

A detailed list of side effects can be obtained from the Patient Information Leaflet. Please ask your medical team for a copy.

Your doctor or nurse will ask you to stay at the clinic for a short while, to check that you are comfortable following your treatment.

As with all procedures, you may experience some common side effects. Very rarely there is some pain around where the injection was given. The majority of patients do not experience pain or tightness.

No specific follow up appointment is required however, you may need or choose to have this treatment once every 12 weeks approximately depending of consultation with your prescribing doctor.

When you enquire you will be asked to attend an initial consultation with the Consultant Neurologist. This is to determine eligibility for the Botox® for migraine treatment as the medication is not suitable for all. Your Consultant will explain this to you.

If you’re eligible, we’ll book you in for treatment. After each treatment session, your Consultant will discuss whether you need further treatment, which you can book while you’re at the hospital.