PMID: 11903527Mar 21, 2002Paper

Botulinum toxin type A and EMG: a key to the understanding of chronic tension-type headaches?

Headache
J D RollnikR Dengler

Abstract

The pathogenesis of chronic tension-type headache remains unclear, and the role of muscle tension is especially controversial. Botulinum toxin type A, a potent inhibitor of muscle tone, has been used to treat chronic tension-type headache. To determine whether clinical response to treatment of chronic tension-type headache with Botox A parallels changes in resting muscle activity recorded through serial electromyography (EMG). We randomly assigned eight patients with chronic tension-type headache to pericranial injection of 500 MU Botox A versus placebo (isotonic saline). At 6 and 12 weeks following treatment, there were no significant differences in clinical outcome between the placebo and the Botox A groups. This occurred despite EMG evidence of a reduction in resting muscle activity in the Botox A-treated patients. These results support the hypothesis that peripheral mechanisms such as increased muscle tone play, at most, a minor role in the pathophysiology of chronic tension-type headache.

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Citations

Oct 3, 2002·Current Pain and Headache Reports·M Vandenheede, Jean Schoenen
Aug 7, 2002·Current Treatment Options in Neurology·Ninan T. Mathew, Alex O. Kaup
Nov 8, 2002·Cephalalgia : an International Journal of Headache·S EversI-W Husstedt
Feb 7, 2003·The Clinical Journal of Pain·Elizabeth Loder, David Biondi
May 29, 2004·Current Opinion in Otolaryngology & Head and Neck Surgery·Stefan Evers
Jan 7, 2006·Cephalalgia : an International Journal of Headache·R B LeistadL J Stovner
May 8, 2008·Cephalalgia : an International Journal of Headache·C Fernández-de-las-PeñasD Farina
Jul 21, 2011·Indian Journal of Psychiatry·Ravi Gupta, Manjeet Singh Bhatia
Jul 28, 2004·Anesthesiology·Steven P CohenSalahadin Abdi
May 17, 2006·Current Opinion in Neurology·Stefan Evers
Nov 26, 2008·The Journal of Headache and Pain·Sherif M HamdyRasha Hasan
Dec 21, 2007·Lancet Neurology·Arnaud Fumal, Jean Schoenen
Jun 18, 2005·Anaesthesia·L C de Gray, B F Matta
Oct 29, 2003·Physical Medicine and Rehabilitation Clinics of North America·Paul Winner
Jun 3, 2004·Primary Care·Curtis P Schreiber
Jun 3, 2004·Primary Care·John Claude Krusz
Nov 25, 2014·Current Pain and Headache Reports·Shengyuan Yu, Xun Han
Dec 4, 2003·Expert Opinion on Pharmacotherapy·Chonghao Zhao, Mark J Stillman
Jan 5, 2006·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Christine M ChengRosalie P Patel
Aug 28, 2004·Headache·Andrew Blumenfeld
Feb 12, 2019·Pain Practice : the Official Journal of World Institute of Pain·Brin Freund, Aruna Rao
Nov 27, 2019·Journal of Oral Rehabilitation·Martin ÅgrenMattias Pettersson
May 1, 2021·Journal of Clinical Medicine·Michał Ginszt, Grzegorz Zieliński

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