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The use of Botulinum Toxin-A in the treatment
of refractory cluster headache: Case Reports
B.J. Freund
Posted Nov 2000
Cephalalgia, May 2000

Objective: To report the treatment with Botulinum toxin-A (BTX-A) of two healthy males, aged 38 and 46 years, with histories of cluster headache of over 10 years' duration. Each suffered from clusters averaging four headaches per week over a period of 3-4 weeks. The average time between clusters was 3 months. Both subjects found ergotamine worked with moderate effectiveness although prophylactic therapy proved ineffective.

Conclusion: Six days and 9 days, respectively, post injection, both subjects reported an abrupt cessation of headache. This corresponded with a subjective sense of weakening of the chewing muscles. No other adverse effects were reported. The headache-free period lasted for 10 and 12 weeks, respectively. Both subjects were re-injected in a similar fashion and had a second headache-free period of 19 and 21 weeks.