This document outlines the risks, benefits, and expectations for the use of OnabotulinumtoxinA (Botox) in the treatment of chronic migraines.

1. Treatment Overview

Botox is FDA-approved for the prophylaxis (prevention) of headaches in adult patients with Chronic Migraine (15 or more days per month with headache lasting 4 hours a day or longer).

The procedure involves multiple small injections (typically 31 sites) across seven specific muscle areas around the head and neck. Treatments are usually administered every 12 weeks.

2. Potential Benefits

• Reduction in the frequency of headache days.

• Reduction in the intensity of migraine symptoms.

• Improved quality of life and daily functioning.

• Note: Results are cumulative and may take 2–3 treatment cycles to reach maximum effectiveness.

3. Risks and Side Effects

While generally well-tolerated, potential side effects include:

• Common: Injection site pain, swelling, bruising, or redness; neck pain; muscle stiffness; or a temporary “heavy” feeling in the forehead.

• Ptosis: Temporary drooping of the eyelid or eyebrow.

• Flu-like symptoms: Mild fatigue or headache immediately following the procedure.

• Rare/Serious: Difficulty swallowing, speaking, or breathing. If these occur, seek emergency medical attention immediately.

4. Contraindications

I confirm that:

• I am not pregnant or breastfeeding.

• I do not have a known allergy to any botulinum toxin product (e.g., Xeomin, Dysport).

• I do not have a skin infection at the planned injection sites.

• I do not have a neuromuscular disorder (e.g., ALS, Myasthenia Gravis).

5. Post-Treatment Instructions

• Do not rub or massage the injection sites for at least 24 hours.

• Keep your head upright for 4 hours following the procedure.

• Avoid strenuous exercise or high heat (saunas/steam rooms) for 24 hours.