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Controversies in Neurology
January 2008

Headache Therapy With Botulinum Toxin: Form Over Substance

Author Affiliations

Author Affiliations: Departments of Pediatrics and Neurology, Ohio State University, Columbus (Dr Pakalnis), and Department of Neurology, University of Oklahoma, Oklahoma City (Dr Couch).


E. S.RoachMD

Arch Neurol. 2008;65(1):149-151. doi:10.1001/archneurol.2007.21

Headache is one of the most common neurologic problems encountered in clinical practice. Migraine affects about 15% of the adult population in the United States.1 Frequent migraine attacks can be disabling and cause significant limitations in work, family, and social responsibilities, especially because many individuals with migraine are in their prime years of life for working and family rearing. Even more disruptive are the chronic headache disorders (15 or more headache days per month, according to criteria from the International Classification of Headache Disorders II).2 These headaches probably affect about 4% of the population worldwide; they are more frequent and sometimes more disabling than other chronic neurologic disorders such as epilepsy.3,4 In addition, overuse of over-the-counter and prescription medications by individuals with chronic headache can lead to significant adverse effects as well as other complications.

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