Can Botox help chronic migraines at age 65?

Question

Hi doctor,

I have a sister who is 65 and has had chronic migraine headaches for many years. She has headaches multiple times a month, often with nausea and photophobia, and oral medications have been intermittently helpful.Now her neurologist has suggested Botox injections as a preventative treatment, but she doesn’t know if they work as well at her age and she’s worried about any side effects.I am 65 years old and have chronic migraine . Can I get Botox for migraine ? How long before results ?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will definitely help you with it.

It’s very normal that your sister has questions about beginning a new treatment, especially after suffering from chronic migraines for so many years and not finding consistent relief from medications.

The good news is Botox still works for chronic migraine prevention at age 65 and you can’t be ruled out just because of age. It is tolerated very well by many older adults, especially when given by a skilled neurologist with the standard migraine injection protocol.

Botox is different from pain medications because it is used as a preventive treatment to decrease the frequency and sometimes the severity of migraines. It is most often prescribed for people with chronic migraines, which are headaches that occur on 15 or more days a month.

Usually, progress is a slow, not an instant, process. Some people have mild benefits over the first weeks after the initial injections, but many patients need two and sometimes three treatment cycles to see the full effect.

Injections are normally repeated every 12 weeks, so doctors usually say it should be given at least six to nine months before deciding if it is helping enough. The aim is usually to decrease the number of headache days, severity of attacks, and need for rescue medications and to improve day-to-day functioning rather than to eliminate migraines.

Side effects are usually localised and transient. Most commonly

Neck pain.
Soreness at the injection site.
Mild headache post-treatment.
Temporary weakness of the muscles of adjacent areas.
Some people experience a feeling of heaviness in the forehead or mild eyelid drooping, although this is usually temporary and less common when injections are done carefully.

Serious complications are rare at migraine therapy doses. Before she starts, her neurologist will check her general health, her medications, her muscle strength and other neurological conditions.

It may be helpful to keep a migraine diary before and after starting treatment so that she can objectively track the change in headache frequency, severity, triggers, and medication use. Even a partial improvement can make a big difference to quality of life, energy, sleep and independence.

I hope this is clear, and if you have any questions, do not hesitate to ask.

Do follow up whenever needed.

Let me know if I can assist you further.

Thank you.