Welcome to Neurology Consultants of San Antonio Migraine and Headache Treatment Center
Botox Injection for Chronic Migraine:
Botulinum toxin A (Botox) has been approved by the Federal Drug Administration for treatment of chronic migraine. The administration of botulinum toxin A is accomplished by injecting a small amount of medicine into the muscles of the head and neck. Any benefits resulting from Botox tend to wear off after about 3 months with a repeat injections required if benefit is to be maintained. Injections are done every 12 weeks with maximal effect peak achieved after approximately 24 weeks.
The potential side effects of Botox used for chronic migraine include:
- Temporary, and usually mild, facial weakness with facial injections
- Temporary, and usually mild, head or neck weakness with head/neck injections
- Reduction or loss of forehead facial animation due to forehead muscle weakness
- Eyelid drooping (ptosis)
- Pain at the site of the injection or ecchymosis (black and blue mark) at the site of injection
- Dry eye
- Double vision
- Potential unknown long-term risks
It is also possible that as with any injection, there may be an allergic reaction or no effect from the medication. Reduced effectiveness after repeated injections is sometimes seen and rarely infection at the injection site may occur. All care will be taken to prevent these side effects. If therapy is given over a long time, atrophy and wasting in the muscle injected may occur. Occasionally patients become refractory (no longer effective) to treatment because they developed antibodies to the toxin and in this event, therapy needs to the modified.
Occipital Nerve Block for occipital neuralgia:
An occipital nerve block is done when there is inflammation of the occipital nerves (located in the back of the head) that is causing headaches. Local anesthetics and a steroid are injected into the occipital region in order to reduce inflammation of the nerves and provide pain relief. This procedure does come with possible risks. Complications that can occur include but are not limited to bruising, infection, and adverse reaction to the medication. Administration of a steroid medication may cause side effects. Potential side effects include but not limited to elevated glucose levels, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, or osteoporosis. Alternatives to the procedure include oral medications, physical therapy, or acupuncture. Benefits include decrease or elimination of your pain. Risks include infection, bleeding, bruising, allergic reaction, increased pain, nerve damage involving temporary or permanent pain/numbness or weakness. Any benefits resulting from the procedure tend to wear off after about 6-8 weeks with a repeat injections required if benefit is to be maintained. Injections are done every 8 weeks with maximal effect peak achieved after approximately 16 weeks.
Toradol Injection for acute pain:
Ketorolac tromethamine (Toradol) is a nonsteroidal anti-inflammatory (NSAID) medication used for the short-term treatment of moderate to severe pain. You will be administered a dose directed by Dr. Tarbox or PA Thomas into a muscle. You may have a maximum of 2 injections within a 7 day period unless otherwise directed by Dr. Tarbox or PA Thomas. Ketorolac should not be used for mild or long-term painful conditions such as arthritis. This drug may cause serious, rarely fatal bleeding from the stomach or intestines. We do not recommend the use of this medication if you have stomach or intestinal problems such as bleeding or ulcers. We also do not recommend taking Toradol if you took high doses of aspirin (325mg) or other nonsteroidal anti-inflammatory drugs within 48 hours from requested injection. Pain at the injection site, dizziness, drowsiness, or stomach upset may occur.
We currently offer the following…