Migraine is a chronic disease caused by the hypersensitivity of the core of the trigeminal nerve that receives the sensation of the face and head region. Migraine may be triggered by external stimuli such as cold, light, odor, and mood disorders such as sleep, hunger, depression anxiety may also initiate migraine attacks due to their connection to many systems in the brain.

The effect of the trigeminovascular system in the migraine, which mainly exacerbates the pain, is the enlargement of the head and brain vessels. Migraine headaches may occur in childhood or even in infancy. However, the effect of hormones in adolescence, the age and age of 35-45 years after the introduction of stress factors, the frequency and severity of pain in daily life is becoming.

Up to 10 years ago, migraine treatment consisted only of pain relievers to relieve pain and medications used in different diseases. Botulinum toxin is a drug that has been found to be the gold standard of treatment in many areas since 1989, and has been approved by the FDA in 2009, specifically for the mechanism of chronic migraine. The effectiveness and safety of the drug has been recorded with thousands of studies and patients. There is clear scientific evidence for its use in migraine. Botulinum toxin significantly increases the number of painless days in chronic migraine patients and enables the patients to return to daily life with an increase in quality of life.

Medications used during attacks of migraine are not suitable for long-term use. Triptan group drugs that we know are effective at the beginning of these. Botulinum toxin is the only approved treatment option in chronic migraine as an effective and safe treatment for patients who have had a frequent attack for more than 15 days.

Erenumab is approved by the FDA for migraine prevention (prophylaxis). In patients with a monthly number of headache days between 4-15 months, with the application of one injection per month, approximately 40% of patients at the 3rd month reduced the number of migraine headache days by 50%. Lifestyle change is a treatment option developed for migraine in cases such as acute treatment. However, the monthly treatment costs and the effectiveness of the patients on the number of headache days in real life should be assessed by the expert neurologist.

Nerve blockages are among the economic options for patients who cannot benefit from classical drugs in migraine treatment. The most effective and safe medication is botulinum toxin in patients with migraine headache counts over 3 months, migraine headache days 8, and headache days 15 and over.


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