Hautmedizin Westend – Dermatology | Laser | Aesthetics

Botulinum Toxin for Chronic Migraine

For chronic migraine, botulinum toxin is a licensed preventive treatment – we inject according to the approved scheme, every twelve weeks, in coordination with your neurologist.

The treatment

Botulinum toxin type A is licensed as a preventive treatment for chronic migraine. We carry out the injection according to the approved scheme – the diagnosis and the decision to treat rest with your neurologist.

The injections are given with a very fine needle, shallowly into the muscles of the forehead, temples, back of the head, neck and shoulder. How the injection points are distributed is something we discuss with you calmly beforehand. The treatment takes about 15 to 20 minutes and is easy to tolerate without an anaesthetic.

It is repeated every twelve weeks. The effect builds up over the cycles – how well it responds is something we assess together after about two cycles.

Tolerability

The treatment is considered well tolerated; temporary neck pain or a feeling of pressure in the neck may occur, as may mild reactions at the injection sites. We do not treat during pregnancy and breastfeeding, in neuromuscular disorders such as myasthenia gravis, or where there is hypersensitivity to the active substance.

Fees

TreatmentFee
Treatment per sessionfrom €590
Medical consultation and explanation of the procedure€50

For patients with statutory health insurance the treatment is billed as a self-pay service under the GOÄ private fee schedule; where chronic migraine has been confirmed, private health insurers usually reimburse it. As a medical treatment the service is exempt from VAT; the amounts are guide values and depend on the quantity of preparation used.

Frequently asked questions

How does the treatment work?
Using a very fine needle, the injections are given shallowly into the muscles of the forehead, temples, neck and shoulder. The treatment takes about 15 to 20 minutes.
How often does it have to be injected?
Every twelve weeks. How well the treatment responds is something we assess together after about two cycles.
Is the treatment painful?
The individual injections are usually felt as a brief prick; an anaesthetic is generally not necessary.
How much does the treatment cost?
From €590 per session, plus €50 for the medical consultation and explanation of the procedure. For patients with statutory health insurance the treatment is a self-pay service; private health insurers usually reimburse it in cases of chronic migraine.
Who makes the diagnosis?
The diagnosis and the decision to use migraine prophylaxis rest with your neurologist. We carry out the injection treatment.

Source: Fachinformation onabotulinumtoxinA (summary of product characteristics, marketing authorisation for chronic migraine); PREEMPT-Studienprogramm (PREEMPT study programme, Blumenfeld et al. 2010); Cochrane-Review "Botulinumtoxin zur Vorbeugung von Migräne bei Erwachsenen" (Cochrane review on botulinum toxin for the prevention of migraine in adults, CD011616); S1-Leitlinie "Therapie der Migräneattacke und Prophylaxe der Migräne" (German S1 guideline on the treatment of migraine attacks and migraine prophylaxis, DGN/DMKG, AWMF register no. 030-057)