Abstract
Goal. The aim of the study was to compare the results of surface electromyography after injection of Botulinum toxin type A and standard medical therapy. Material and methods. The study encompassed 62 participants with chronic daily headaches (CDH). Group I included 26 patients with chronic migraine (15 treated with BTX-A injection and 11 treated with standard medical therapy), whilst, Group II comprised of 36 patients with chronic tension type headache (20 treated with BTX-A injection and 16 treated with standard medical therapy) with an average age of 32.1 ± 10.3 (M ± SD) years. Before and after therapy, clinical questionnaires, instrumental data, and headache episode characteristics were collected from all patients. To examine the differences between BTX - A injection and standard medical therapy, we measured muscle activity with surface EMG in patients with chronic daily headache before and after 3 months of treatment. On days when the patients had no headache attacks, the surface EMG was measured. Results. After treatment, surface electromyography data revealed a statistically significant difference in outcomes between the patients who received BTX-A injection and those who received standard medical therapy. Before treatment on surface EMG, all patients with chronic daily headache had high amplitude and velocity in the muscles under study, and there was no statistically significant difference between these groups, where p => 0.05. In this study, it was discovered that there was no statistically significant difference in pericranial and neck muscles dysfunction (before treatment between patients receiving BTX-A injection and standard medical therapy in Group I, patients with CM 95% CI -0.9087 - 0.4887; t = -0.607, df = 40, p = 0.5470 and Group II, patients with CTTH 95 % CI -0.5756 - 0.4356, t = -0.27, After treatment, there was a statistically significant difference between groups treated by BTX- A injection and standard medical therapy, with CM 95% CI 0.3258 - 1.4142, t = 3.231, df = 40, p = 0.0025 and CTTH 95 % CI 0.1020 - 1.1780, t = 2.381, df = 58, p = 0.0206, where p = <0.05. Conclusion. The obtained results testify the effectiveness of BTX-A injections compared to standard medical therapy in patients with CDH.
Highlights
ICCD-3 revealed more than 160 multiple kinds of cephalgia, which are classified as primary and secondary
Episodic tension type headache in 24-37% is observed several times a month, in 10% - weekly and about 4-5% of the population suffer from chronic daily headache (CDH) (Lanteri-Minute M. et al, 2003; Dodick D.W., 2006), while from 0.4% to 2.4% of patients suffer from Chronic migraine (CM) [Castillo, 1999; Katsarava et al, 2008; Scher et al, 2009]
Chronic migraine (CM), chronic tension type headache (CTTH), and abusus cephalgia are the major causes of CDH in 95-98 percent of patients, whereas CDH is symptomatic in just 2-5 percent of cases [Tabeeva G.R., Vein A.M., 1999; Welch.., Goadsby P.J., 2002; Goadsby P.J., Boes C, 2002; Dodick D.W., 2006]
Summary
ICCD-3 revealed more than 160 multiple kinds of cephalgia, which are classified as primary and secondary. Cluster cephalgia, chronic paroxysmal hemicrania, and tension type headache are all examples of primary headaches. Episodic tension type headache in 24-37% is observed several times a month, in 10% - weekly and about 4-5% of the population suffer from chronic daily headache (CDH) (Lanteri-Minute M. et al, 2003; Dodick D.W., 2006), while from 0.4% to 2.4% of patients suffer from CM [Castillo, 1999; Katsarava et al, 2008; Scher et al, 2009]. Chronic migraine (CM), chronic tension type headache (CTTH), and abusus cephalgia are the major causes of CDH in 95-98 percent of patients, whereas CDH is symptomatic in just 2-5 percent of cases [Tabeeva G.R., Vein A.M., 1999; Welch.., Goadsby P.J., 2002; Goadsby P.J., Boes C, 2002; Dodick D.W., 2006]. Inadequate expertise in recognizing primary and symptomatic headaches leads to an unjustifiable increase in symptomatic cephalgia diagnoses and erroneous treatment methods, which leads to a chronification of the process
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