Is Peripheral Trigger Therapy by Botox for Migraines the Same or Different Than What Neurologist Perform?

I had botox injections done by a headache specialist that performs it in the standard FDA approved fashion(in forehead and band-like fashion around head). This did not help my migraines at all. I heard some highly trained plastic surgeons look for finding the specific location of the headaches trigger point and inject botox in those areas. Is this the same as what neurologist/headache specialist do? Would it be benificial to seek out a plastic surgeon that does this 'peripheral trigger therapy'?

Doctor Answers 3

Is the cause or trigger of migraines understood well enough to know exactly where to inject Botox?

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It may be too early to determine exactly where the botox should be injected to effect a smoother result. Triggers may not be absolute. If there is a consistent trigger zone then Botox injections may indeed help.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox for peripheral triggers in migraine

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Botox for migraine can be variable in response not only where it is administered but also depending on what is causing the compression.  For instance, when I decompress the frontal trigger site there is typically bone encircling the nerve which needs to be released and this will not be treated by botox.  Therefore you may get partial relief but not full.  This is among many factors of differing responses to botox therapeutic.  I hope this helps.

Michael A. Fallucco, MD, FACS
Jacksonville Plastic Surgeon

Botox Affects Sensory And Motor Nerves In Migraine

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The role of myofascial trigger point injections for Migraines with BOTOX is under study and review.

There very likely would be value in injecting specific migraine triggering myofascial points with BOTOX. 

Just doing the anatomic migraine injecitons per the FDA may not be sufficient.  So discuss with your

neurologist if specific trigger points or muscular groups could have some additonal spot

teatment. There are a wide variety of muscles injected with BOTOX for migraines.  So perhaps your

physician, or a new physician would modify the treatment for your benefit.  There should not be harm.

Good luck.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.