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Mechanism of Action of Botulinum Toxin Type A
in Migraine Prevention: A Pilot Study
Smuts JA, Schultz D, Barnard A.
Posted: December 2004  
Headache 2004;44:801-805

Objective:   The main objective of this study is to determine whether change in migraine frequency is correlated with a denervation pattern of the corrugator muscle after local botulinum toxin type A injections.

Background:   Recent studies suggest botulinum toxin type A is effective in preventing migraine. Relaxation of the corrugator muscle may be one of multiple targets of botulinum toxin type A in relieving migraine pain.

Results:   A 50% decrease in compound muscle action potential was demonstrated in the total group by day 7. Maximal decline was observed by day 30, and was sustained at day 60. Migraine frequency declined by 50% or more in 7 of 10 patients by day 60. Migraine response to botulinum toxin type A treatment did not correlate with the denervation pattern.

Conclusion:   Relaxation of the corrugator muscles is not solely responsible for the pain relief in migraine patients treated with botulinum toxin type A.