Chronic migraine is a common neurological condition characterized by severe, prolonged headaches often accompanied by nausea, sensitivity to light, and noise. This condition significantly impacts daily life and overall quality of life. It arises when pain pathways in the brain are activated, leading to a hypersensitive central nervous system where even minor stimuli can trigger a headache.

Beyond conventional migraine prevention medications, botulinum toxin type A (botox) injections are currently a supportive treatment for chronic migraine headaches. Botox works by relaxing muscles and directly influencing the pain generation mechanism. When injected into anatomical areas associated with headaches, botox inhibits the release of pain-transmitting mediators such as CGRP, substance P, and glutamate from sensory nerve endings. These substances are crucial in initiating and sustaining migraine attacks. Reducing these substances helps control neuroinflammation and brain sensitivity, thereby moderating pain signals sent to the brain and reducing reliance on medication.

A doctor is injecting botox to treat a patient. *Tam Anh General Hospital*

Botox injections for migraine treatment offer localized effects, with minimal systemic impact, and are typically performed on an outpatient basis. A physician first evaluates the patient to confirm chronic migraine criteria, then injects botox into standard locations around the forehead, temples, back of the neck, and neck-shoulder area, following a specific protocol. The procedure is quick, involving very small injections, allowing patients to resume normal activities afterward. Noticeable improvements typically appear after 7-14 days, become most pronounced after about one month, and last for 3-4 months, after which booster injections may be administered.

Side effects from botox injections for migraine treatment are uncommon. They primarily include mild pain, tightness, or slight bruising at the injection site, which typically resolve spontaneously after a few days. A few patients might experience transient neck fatigue. If you experience headaches lasting many years, frequent recurrences, or if painkillers are ineffective, it is advisable to consult a neurologist for suitable treatment options. Botox injections must be performed by a specialist physician to ensure both safety and efficacy.

Dr. Nguyen Hoang Minh Thao

Department of Neurology, Neuroscience Center

Tam Anh General Hospital, Ho Chi Minh City