BOTOX Treatment for Migraine
BOTOX Treatment for Migraine

BOTOX Specialists


Headache Care Center physicians have been treating clinic patients with BOTOX® injections for over 10 years and have performed multiple research studies to determine the most effective use of BOTOX® to treat migraine. As a result, we have honed in on the most effective locations for injections and what type of patients tend to respond the best. Between clinical experience and research, our physicians are very experienced in performing this technique. 

The PREEMPT Study was conducted by our research division, Clinvest, along with other sites throughout the country. This study was the basis for the Federal Food and Drug Administration (FDA) giving approval for the use of BOTOX® in the treatment of chronic migraine. Chronic migraine is defined as 15 or more headache days per month, each headache lasting 4 hours or more, with 50% of the headaches being migraine or probable migraine.  Because of his extensive work in this area, Dr. Cady was selected as a National Trainer for physicians who wish to learn this technique in accordance with FDA guidelines.

What is it?
BOTOX® (onabotulinumtoxinA) is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.

It is not known whether BOTOX® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).

How does it work?
BOTOX® blocks chemical changes on nerve endings. To treat chronic migraine, BOTOX® is injected into muscles of the forehead, the side and back of the head, and the neck and shoulders to produce a partial and temporary chemical “denervation” of the muscle. This causes the muscles to be too weak to contract. The dosage used to treat chronic migraine is very low since the muscles injected are small.

Doctor Discussion Guide

We strongly recommend the injections be performed by a physician trained in this procedure and experienced in treating migraine.


BOTOX® may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX®:

  • Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months

  • Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX® has been used at the recommended dose to treat chronic migraine.

Do not take BOTOX®if you: are allergic to any of the ingredients in BOTOX® (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc®(rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.

The dose of BOTOX® is not the same as, or comparable to, another botulinum toxin product.

Serious and/or immediate allergic reactions have been reported. These reactions include itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you experience any such symptoms; further injection of BOTOX® should be discontinued.

Tell your doctor about all your muscle or nerve conditions such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX®.

Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® can harm your unborn baby); are breastfeeding or plan to breastfeed (it is not known if BOTOX® passes into breast milk).

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® in the past.

Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take anti-platelets (aspirin-like products) or anti-coagulants (blood thinners).

Other side effects of BOTOX® include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Please see BOTOX® full Product Information including Boxed Warning and Medication Guide.



Very simply, Botox has given me most of my life back. I had daily migraine headaches when I sought out the Headache Care Center. I was so very tired of trying medications that didn’t work or had horrible side effects. Dr. Cady and Dr. Dexter tried Botox quickly at the onset of their treatment strategy for me and I had amazing results. It took a couple of weeks to feel the full effects, but I have had at least two thirds of each month nearly or completely headache free. I feel confident that I can eventually become completely headache free with this treatment. I would recommend it to anyone suffering as I did.”


“Botox has been a part of my migraine preventive care for several years now. To refer to Botox as a ‘cure’ for migraines in my opinion would be an inaccurate claim. However, I have gone from a dozen or more migraines a month to only two migraines in the last 6 months; both of which were ended quickly by my rescue medication. Botox is a vital factor in managing my headaches. I’m so very thankful for everyone at Headache Care Center!”


“I have experienced migraines since I was a child and have tried everything on the market from Imitrex to acupuncture. I’ve had various cycles with my migraines throughout my life, but I was at an all-time high of headaches during a month when I found Botox. My doctor saved my life when he split my headaches in half with the first set of injections. I now have more valuable time to spend with my husband, children and grandchildren. I can schedule trips easier, and my daily life is getting so close to normal that I feel so blessed to have found this treatment.” 

How can you get BOTOX® injections for chronic migraine?

  • Call Headache Care Center at 417-890-7888 or toll free 866-899-0745
  • If you prefer, email your contact information and our Nurse Manager will contact you.


1. BOTOX® Prescribing Information, January 2013


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