Find out more about
BoNTA injections, highly diluted botulinium toxin type A, works to prevent migraine by blocking the release of a neuropeptide in the sensory nerves that transmits the pain signals in headache. Research into using BoNTa to treat migraines began after patients receiving it for other conditions, like facial wrinkles, reported improvement in their migraine symptoms. Our Dr. Filipović was part of the research team that found the exact mechanism of BoNTA in migraine and other headaches. This group in that last 10 years published more then 30 international publication on that subject.
BoNTa is different from other types of preventive headache treatments: It is a procedure that is administered every 12 weeks as an ongoing prevention method. The procedure is comprised of multiple injections located in the forehead, temples, back of the head, and the neck that target the nerves that are typically activated during migraine.
The anatomy of head and neck muscles must be well understood not to distort facial symmetries. As additional benefit of this procedure patient can get rid of the many facial wrinkles in the forehead area, which our female patient especially like.
- Safe and non-invasive procedure to treat headache symptoms
- Long term effect (12 weeks) after 1 injection session
- No downtime
- Preventive treatment
Good candidates are patients with:
- Chronic migraine patients
- Patients with history of medication failure
- Intolerable side effects to previous treatments
Not good candidates are patients with:
- Developed antibodies to Botox – in which case treatment is ineffective
WHAT RESULTS TO EXPECT?
BoNTA injections are suitable for patient who has experienced intolerable side effects to previous treatments or general ineffectiveness of drug treatments. BoNTa can also be beneficial for patients who are tired of trialing oral drugs and prefer a more locally targeted treatment.
Each headache patients is different and some may begin to experience modest relief after the first 12 weeks following an BoNTa treatment - the initial result might just be reduced headache severity. Research shows that patients can see a significant reduction in migraine attacks after the second and third rounds of injections, each round separated by 12 weeks.
Research results of BoNTA activity can be summarized as:
- 81 % patient reported less frequent and/or less intense headache
- 61 % reported excellent pain relief
- 20 % reported some pain relief
After two treatments, patients reported that they had up to nine fewer headache days a month.
If after the third round, patients do not see any change in the frequency or severity of their headaches, then it may be time to consider an adjunctive medication or an alternative treatment option like migraine surgery.
HOW TO PREPARE FOR TREATMENT?
No pre-treatment protocol is needed in case of botulinum toxin injections.
Your surgeon will ask you about your past medical history, medications, allergies, previous surgery and more. You are to avoid taking aspirin, anti-inflammatory drugs, warfarin sodium and other supplements as they can increase bleeding and bruising.
It's important to understand all aspects of BoNTA injection. It's natural to be nervous about it so don't be shy to discuss your concerns with your doctor.
Know more about
In the headache center of the LF-Medical group we have developed our injection protocol that uses minimally required doses of BoNTa to achieve effect on headache without altering facial mimics and harmony. On average, each treatment requires around 32 injections, though individual patients may require fewer or more.
Depending on your symptoms, BoNTA may be injected into:
- Both temples
- Back and sides of the neck
- Upper shoulders
- Back of the head
You’ll receive injections every 12 weeks, and each session only takes a few minutes. BoNTA begins to work in few days, and you should see full results within a week of your first injections.
BoNTa is injected using a very fine 32G needle. Before injection we will numb the face and neck with the anesthetic cream. In our practice we use New Local Vibration Anaesthesia - NeuvibeTM so the injection is almost pain free. Most patients describe it as feeling like a tiny pinprick.
The effects are temporary lasting in duration from weeks to months. Most patients who benefit from treatments receive 4 rounds of injections over 12 months.
Time to heal
- There is no down time or recovery time for botulinum toxin injections
- You may resume normal activities immediately.
One note of caution:
- Don't rub or massage the treated areas after the Botox treatment because it can cause the botulinum toxin to migrate to another area of your face. If this happens, you might experience temporary facial weakness or drooping.
Although generally safe, botulinum toxin side effects and complications can include:
- Bruising and pain at the injection site
- Flu-like symptoms
- Temporary facial weakness or drooping
These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your doctor.
They will take care of you
MEET THE TEAM
PETER JFM LOHUIS, MD PHD
BORIS FILIPOVIĆ, MD PHD
IVANA JURJEVIĆ, MD PHD
MARINA MILOŠEVIĆ, MD
FREQUENTLY ASKED QUESTIONS
· When complication happens, two things are important – to immediately identify the complication, and to initiate prompt treatment.
· Depending on the type of the complication the treatment will defer from medication, to just reassurance.
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