Botox for chronic migraine.
The PREEMPT protocol — when medications have plateaued.
OnabotulinumtoxinA, delivered using the FDA-approved PREEMPT protocol, for adults with chronic migraine who have not gotten enough relief from oral preventives.
A preventive treatment for chronic migraine.
Botox for migraine is not a cosmetic treatment and not a single-site injection. The PREEMPT protocol delivers thirty-one small injections across seven head and neck muscle groups, in fixed locations, every twelve weeks. The mechanism is not fully understood, but consistent randomized data shows reductions in monthly migraine days for many patients with chronic migraine — defined as fifteen or more headache days per month, of which at least eight are migrainous.
A standardized fifteen-minute injection sequence.
You sit upright. The thirty-one injection sites are marked. Each injection is a small volume of reconstituted onabotulinumtoxinA delivered with a fine needle into superficial muscle. The full sequence takes ten to fifteen minutes. Most patients report the discomfort as comparable to multiple pinpricks. No sedation. You leave and resume your day.
For chronic migraine that has not responded to oral preventives.
Botox is FDA-approved specifically for chronic migraine. The strongest candidates are adults with fifteen or more headache days per month who have failed at least two oral preventive medications. We also use it for select cases of refractory tension-type headache and certain mixed headache syndromes. It is not indicated for episodic migraine fewer than fifteen days per month.
Effect builds over weeks. Re-treatment every twelve weeks.
Most patients do not feel an immediate effect. Onset of benefit typically occurs over the first two to four weeks after injection, with maximum effect at six to eight weeks. The standard treatment cadence is every twelve weeks. We measure success by reduction in monthly headache days and headache severity, not by complete elimination. Two to three treatment cycles are reasonable before assessing whether to continue.
Stop accepting the downtime.
A standardized protocol with measurable results. Schedule a consultation at any Triumph location.