Comparison of Botox® or Prosigne® and Facial Nerve Blockade as Adjuvant in Chronic Migraine


Background: The treatments suggested for chronic migraine (CM) include: 1) intramuscular (im) botulinum toxin (BTX) every 12 weeks, and 2) blockade of peripheral nerves of the head. The present study evaluated the efficacy of facial nerve blockade in combination with a single administration of different low BTX. Methods: Forty patients with CM submitted to unilateral facial nerve blockade (supraorbital, supratrochlear and auriculotemporal) were divided into 4 randomized groups in a double-blind manner in order to receiveim, after 7 days: 25 IU Botox® (Botox group), 25 IU Prosigne® (25-Pro group), 33.3 IU Prosigne® (33-Pro group) or saline (control group), with the dose divided for application to 10 sites in the frontal and bilateral temporal regions. Analgesia and adverse effects were evaluated: 1) before blockade of the facial nerves and 2) 4 weeks, 3) 8 weeks and 4) 12 weeks after BTX-A or saline application (HC clinical trial no. 12465). Results: Botox® (25 IU) or Prosigne® (33.3 IU) resulted in at least seven-day intervals between headache attacks associated with 70% reduction in frequency and intensity of crises over 12 weeks (P < 0.05), while the 25 IU dose of Prosigne® resulted in 8 weeks of analgesia. The conversion factor between Botox® and Prosigne® was 1:1.3. Conclusions: Im application of Botox® (25 IU) or Prosigne® (33.3 IU) one week after nerve blockade on the painful side was equally effective for 12 weeks in patients with chronic daily headache, with the conversion factor between Botox® and Prosigne® being 1:1.3.

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Lauretti, G. , Rosa, C. , Kitayama, A. and Lopes, B. (2014) Comparison of Botox® or Prosigne® and Facial Nerve Blockade as Adjuvant in Chronic Migraine. Journal of Biomedical Science and Engineering, 7, 446-452. doi: 10.4236/jbise.2014.78047.

Conflicts of Interest

The authors declare no conflicts of interest.


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