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Abstract Details

Is Botulinum Toxin Effective in Treating Menstrually Related Migraine?
P6 - Poster Session 6 (12:00 PM-1:00 PM)
Chronic migraine is a condition that causes significant impairment and affects up to 3% of the population.  Women are three times more likely to suffer from migraines than men (1), and up to 70% have migraines associated with menstruation (2).  Botulinum toxin is FDA approved to treat chronic migraines and given a possible similar pathophysiological mechanism, it could also be a therapeutic option in menstrually related migraines (1).  To date, no studies have specifically evaluated the efficacy of botulinum toxin in the treatment of menstrually related migraines.
To elucidate the efficacy of botulinum toxin in treating menstrually-related migraines in those with comorbid chronic migraine.
This was a retrospective study of the efficacy botulinum toxin in menstrually related migraines at the Naval Hospital in Jacksonville, FL from January, 2018 to August, 2019.  We included patients who were diagnosed with chronic migraine, received botulinum toxin per the PREEMPT protocol, responded by at least 50% decrease in overall headache frequency, and also reported a history of menstrually related migraine.
10 patients were included in this study.  9/10 patients were still experiencing regular monthly menstrual cycles, with one patient menstruating every 3 months.  The average headache frequency was 20.9 days per month prior to instituting botulinum toxin.  Despite a mean decrease in headache days per month of 13.9 (62%), there was no change in the duration or severity of each patient's menstrually related migraines.
This is the first study of the efficacy of botulinum toxin in chronic migraineurs with comorbid menstrually related migraines.  Despite its clear efficacy in chronic migraine, botulinum toxin may not be as effective in treating menstrually related migraines.  Female patients should be counseled regarding their menstrually related migraines when instituting botulinum toxin and future studies should evaluate botulinum toxin and other newer therapies in treating this common and debilitating condition.
Brin Freund, MD
Dr. Freund has nothing to disclose.
Natalie Castro No disclosure on file
Almer Mendoza No disclosure on file