A Mayo Clinic case study finds Botox may offer new hope to patients
suffering disabling low cerebrospinal fluid headaches. The successful
treatment also offers new insight into Botox and headache treatment
generally. The case study was presented March 13th, 2011 at the American
Academy of Neurology meeting in Hawaii.
Low CSF pressure headaches are caused by an internal spinal fluid
leak. The pain can range from slight to disabling. The headaches are
most commonly triggered by a lumbar puncture. The pain is caused as
fluid leaks out and the brain sags. For many patients, lying down has
offered the only relief, because existing therapies weren’t fully
effective. Traditional treatment is a blood patch, which is just that: a
patch of the patient’s blood injected over the puncture hole.
The patient in the case study suffered low CSF pressure headaches for
25 years. For most of that time, she only felt better while lying down,
curtailing her day-to-day activities. Five years ago, she sought help
from Michael Cutrer, M.D., and Paul Mathew, M.D. The patient has
received Botox for three years and the results have been consistently
positive. After each treatment, improvement would last for three months
before pain returned, requiring another dose. While not cured, the
patient is now able to live a more normal life.
“We had been using Botox for several years for treatment of migraine
and had been successful in many patients. And because we really didn’t
have anything else to offer her, we gave her the Botox,” says Dr.
Cutrer, a neurologist at Mayo Clinic in Rochester, Minn., and the
report’s co-author. “To everybody’s surprise she made a remarkable
improvement.” The intensity of the patient’s headaches dropped from 8
out of 10 on a visual pain scale to 3 out of 10.
To learn more about spinal headaches, go to: http://www.mayoclinic.com/health/spinal-headaches/DS00643.
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