Botox en la migraña crónica

Objective: To review the evidence of efficacy of Botox in chronic migraine (CM), its critique and the key findings from prospective data on real life patients. Development: CM is the most disabling form of migraine that affects around 2% of the general population and has significant impact on the quality of life of an individual with reduced ability to work or perform various activities of daily living. Medication used for prophylaxis of episodic migraine may well work in CM, although only topiramate has the published evidence. Botox was licensed for CM prophylaxis following publication of results of randomized controlled study (PREEMPT). Recently results of a large cohort of real life patients have been published (data from Hull Migraine Clinic, United Kingdom). Conclusions: Hull Migraine Clinic study provides the first prospective real-life data on patients with CM treated with Botox in a tertiary headache centre. It was suggested a revision for defining responder. Nevertheless, the impact of medication overuse on the response, of any predictors for response to treatment, long-term outcome, duration of treatment, development of resistance to Botox and relapse rate after stoppage of treatment remains unclear.