Ask the Clinician with Dr. John Claude Krusz for About Headaches and Migraine: Question and Answer #19 for 5/27/03

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Headaches & Migraines

Dr. Krusz is a recognized expert in the fields of
headache and Migraine treatment and pain treatment
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Please Note: We receive far more questions than can be answered in this format. In many cases, our Guide, Teri Robert, has already researched the topic of the question and may have information already published on this site. Some questions answered here will be answered by Teri. Dr. Krusz will be reviewing her answers before they're posted to see if he can offer additional input.

QUESTION:
Dr Krusz,
     Where can I look up results or more info on Botox injections for migraines?
     I would also like to know how involved the medical community is in helping to see that Botox is approved by FDA for migraine use.
     I have had Botox injections which each time have to be approved by my insurance company first before I can go ahead with the injection. This is a real hassle. The Botox has helped me a great deal although the affect seems to wear off in two months.
     I just wish the medical community trusted its patients more.

Thank you,
Marlene

REPLY:
Dear Marlene:
Basically, a lot of the existing literature on botulinum toxins (type a is Botox, type b is Myobloc) is in headache and pain journals, where original work gets published. Also, research abstract posters get shown at headache and pain meetings. Officially, botulinum toxins are not approved for headache or pain treatment. Your physician may be trying to protect you in getting botulinum toxin injection approved by your insurance company prior to giving it to you. The only diagnosis codes that can be currently used are those relating to muscle spasm. Most of the time, it takes 1-2 phone calls, a hassle, I assure you, for health care and office personnel! I don’t think it’s about lack of trust at all. That the effect wears off is well-known- it may be a matter of dose used, and site(s) injected.
John Claude Krusz

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