Botox May Treat Cluster Headaches: 30-Minute Procedure Alleviates Pain Up To 8 Months

Woman laying on grass
A new 30-minute Botox treatment may alleviate pain from cluster headaches for up to eight months. Shandi-lee Cox, CC BY-NC-ND 2.0

Cluster headaches, also known as “suicide” headaches, can interfere with daily activities as they can occur sporadically throughout the day. Despite the intake of pain reliever drugs such as ibuprofen and acetaminophen, sufferers experience a sharp, penetrating, or burning pain worse than migraines. A new Botox treatment developed by researchers at the Norwegian University of Science and Technology (NTNU), in collaboration with St. Olavs Hospital, may help treat cluster headaches with just a 30-minute procedure that can provide pain relief for up to eight months, according to a NTNU news release.

"I hit myself in the head to distract myself from the pain when I have a cluster headache. The pain is indescribable hell, and in desperate moments, I have hit my head against a brick wall and hit myself in the head with a cell phone,” Hilde Vollan, 34, a Ph.D. candidate in bioinformatics at the University of Oslo, said in the news release.

Vollan is just one of several patients who suffers from the most severe form of headaches: cluster headaches. She always has a bag of pills, including her oxygen bottle, a mask to breathe with, and migraine medicines that she takes by injection since her cluster episodes can occur in the middle of the street or inside a store.

During an episode, patients usually avoid lying down because the position seems to increase the pain. These episodes typically last from six to 12 weeks, according to the Mayo Clinic. The pain of these headaches is generally located in or around one eye, but can also travel to other areas of the body, such as the face, head, neck, and shoulders.

The researchers at NTNU believe the antidote to these headaches lies in Botox. The neurotoxin stops the flow of the impulses along the nerves due to its main ingredient: botulinum. Botulinum is commonly used to prevent wrinkles by disabling the messages sent by nerve cells to contract with muscles (a process which forms wrinkles).

NTNU senior consultant and researcher Erling Tronvik, as well as Daniel Bratbak at St. Olavs Hospital and Professor Ståle Nordgård at NTNU, have developed a new treatment to limit the occurrence and pain of cluster headaches using Botox.

The gear used for this Botox treatment looks like a pistol with a very thin barrel with just the width of a knitting needle. The mouth of the barrel comes to a bundle of nerves behind the sinuses, as the barrel is inserted up the nose of the patient and passes through a natural hole in the nasal wall, Science Daily reports. A dose of Botox is then shot to the area around the nerve bundle after the surgeon pulls the trigger of the pistol. In total, the whole process takes approximately 30 minutes and has a lasting effect from three to eight months.

Tronvik and a team of researchers are now on the brink of setting a pilot study to test the new treatment. They are currently in search of 10 patients, but if the method turns out to be effective, the experiment may later include 30 to 40 cluster headache patients and approximately 80 migraine patients.

In 2010, the U.S. Food and Drug Administration approved Botox treatment for chronic migraine sufferers since the drug blocks the transmission of pain signals to the brain. However, patients have steered clear from this form of treatment because the current Botox injection could paralyze their face.

In this new Botox treatment, the patients will all have to undergo an MRI to make sure the surgeon knows exactly where the nerve bundle is. A navigation tool — consisting of three small spheres on the pistol and a plate with three spheres mounted on the patient’s head — will allow the surgeon to find the nerve bundle based on the MRI image. However, patients who participate in the pilot study must be aware that they may be at risk for temporary double vision or a weakened chewing ability ability if the Botox hits an area near the nerve bundle.

“We hope that this treatment method can help give patients a life without such great pain,” said Tronvik.

To learn more about cluster headaches, click here.

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