Abstract
Objective : Compare the use of Myobloc (Botulinum Toxin Type B) and Botox (Botulinum Toxin Type A) in headache prophylaxis. Background : Data on the use of Botox in the management of headaches have been promising. Similar benefits have been reported with use of Myobloc; yet there are no direct comparisons between the two toxins. Design/Methods : We identified 22 patients receiving either Botox ( N =11) or Myobloc ( N =11) for headache prophylaxis. We compared the clinical features, botulinum toxin regimen, and clinical response of the patients in each group. Results : All patients met IHS criteria for either chronic daily headache or migraine headache. In the Myobloc group, there were 8 females and 3 males, aged 22–89 years old. Total dose used was 1075–8250 units, injected every 3 months, over 6–30 months. In the Botox group, there were 10 females and 1 male, aged 19–70 years old. Total dose used was 40–245 units, every 3 months, over 11–90 months. All 11 Myobloc and 10 of 11 Botox patients reported clinical improvement, manifested by reductions in headache frequency and severity of attacks. Additionally, 81% of Myobloc and 45% of Botox patients reported less abortive agent use. No significant adverse effects were reported. Conclusions : In this study, Myobloc is safe and effective in treating various headache syndromes. Myobloc, similar to Botox, should be considered as an option for headache prophylaxis.
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