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Published on September 09, 2015

New relief for migraines may raise some eyebrowsNew relief for migraines may raise some eyebrows

Ever since her teens, Christine Blake has suffered from migraines, but as she got older, the symptoms got worse.

The headaches would occur at least three times a week and often last for days, leaving her incapacitated. As a young mother with three children under 3, the headaches were not only physically crippling, but also devastating to her family.

“If I don’t work, I don’t get paid,” said Blake, a 47-year-old self-employed behavior analyst who works with autistic children. “I knew I had to provide for my family, which caused a huge amount of anxiety. How long would the migraine last, what would I have to miss, how would I deal with my child’s birthday party if it didn’t go away? It was absolutely debilitating.”

Blake tried everything, from over-the-counter pain medications to a laundry list of prescribed meds, including seizure medicine and antidepressants.

Three years ago, she underwent successful surgery to remove a benign brain tumor, but the migraines didn’t stop. In fact, the headaches got worse, up to 16 to 18 times a month.

“I wasn’t able to live,” Blake said. “My quality of life was so poor. I had severe depression and anxiety. I didn’t know how to pick myself up and put myself on the right path. It was so defeating.”

All that changed when Blake met Dr. Karen Lynch, a neurologist with Cape Cod Healthcare, who is treating migraines by using a decades-old product in a new way.

Botox.

The anti-wrinkle treatment has been around for 25 years, but in 2010, the U.S. Food and Drug Administration approved Botox to treat chronic migraines. The results were “groundbreaking,” Dr. Lynch said. (Today, more than half of all Botox sales come from medical, rather than cosmetic treatments.)

“It’s quite common that many headache and migraine patients are never diagnosed,” Dr. Lynch added. “They go along thinking, ‘Nobody understands me. I just have a headache. I’ve always had a headache. It’s hopeless and nobody knows what to do.’

“And that’s really a myth. We know a lot about this. It is a true disorder, and it’s not just in your head.”

Blake is one of 36 million migraine sufferers in the U.S. That’s one in four homes where someone has some sort of a migraine disorder.

Most of these cases are episodic headaches that happen from time to time. But for 3 million people like Blake, the migraines are a chronic illness occurring more than 15 days each month. Studies have shown Botox to be effective for these patients.

Chronic migraine patients receive shots every 12 weeks in a fixed dose to seven different areas in the head and neck. A vial of Botox typically costs $800 but is covered by insurance when used as a migraine treatment.

After two months, studies show that patients have eight to nine fewer headache days per month. After 12 months, 70 percent of the patients receiving Botox had reduced their number of headaches by more than 50 percent.

Some patients have a dramatic response after the first session of Botox therapy, Dr. Lynch said. But the greatest improvement usually occurs after the second cycle of Botox.

There can be side effects, including neck pain, eye droop, facial weakness or headaches. But because such small doses are used in treatment, Dr. Lynch said the side effects tend to be much less severe. Blake said she has experienced some tightness in her shoulder but nothing serious.

There’s also the stigma of using Botox, which Dr. Lynch said tends to be mostly with older patients and men. One of her patients, a 78-year-old woman suffering from two to three migraines a week, worried how her face would look. She nearly left the office but decided to give Botox a try.

After six weeks, she experienced only two headaches and said she felt like she had a new lease on life, Dr. Lynch said.

As for Blake, after decades of excruciating headaches,she said the results have been remarkable. Nine months after she began the Botox shots, Blake has gone from having 18 migraines a month to three.

And those remaining headaches are not as prolonged or severe, and often go away after Blake takes medications that never used to work. With Dr. Lynch’s help, she has learned how to avoid certain triggers, such as making sure she gets enough sleep.

Above all, Blake has regained something she thought she had lost forever: hope.

“It’s incredibly empowering and so unbelievable that I can do things again, live my life without worrying about getting migraines. I still get them, but they are not debilitating anymore,” she said.

“None of these medications or treatments are cures,” Dr. Lynch said. “But the significant reduction in pain, the days of headaches, the productivity that can be affected, all go into adding quality of life back to patients who suffer from these regularly.

“For my patients, it’s often the simplest things—being able to go to work or out to dinner. They get their lives back.”

For more information, contact Neurologists of Cape Cod at 774-470-2460 or at www.capecodhealth.org/medical-services/brain-neck-spine/neurology.