Botulinum toxin A is effective to treat tension-type headache caused by hemifacial spasm. (October 2017)

• Record Type: Journal Article
• Authors: Mizuma, Atsushi; Nagata, Eiichiro; Yasuda, Takashi; Kouchi, Maiko; Nakayama, Taira; Honma, Kazunari; Tokuoka, Kentaro; Kitagawa, Yasuhisa; Nogawa, Shigeru; Takizawa, Shunya
• Is Part Of: Journal of clinical neuroscience. Volume 44(2017:Oct.)
• Page Start: 284
• Page End: 288
• Publication Date: 2017-10
• Subjects: Hemifacial spasm -- Botulinum toxin -- Primary headache -- Tension type headache -- Cranio-cervical dystonia -- Headache impact test-6; HFS hemifacial spasm -- BoNT/A botulinum toxin type A -- TTH tension type headache -- CH chronic headache -- NRS Numerical Rating Scale -- HIT-6 Headache Impact Test-6; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2017.06.069
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Tension-type headache (TTH) is higher frequently seen in hemifacial spasm (HFS) patients. Stress factors were associated with TTH accompanied by HFS, regardless of the existence of stiff neck and spastic muscles. Botulinum toxin A therapy for HFS may also be indirectly effective for improving TTH. Abstract: Objective: We examined the relationship between hemifacial spasm (HFS; a form of cranio-cervical dystonia) and chronic primary headache, including tension-type headache (TTH). We also examined whether botulinum toxin A (BoNT/A) therapy for HFS ameliorates concomitant TTH. Methods: Fifty-one HFS patients receiving BoNT/A therapy were recruited. Patients' characteristics (including age, gender, chronic headache history, exercise habits, stiff neck, cervical spondylolysis history), stress factors, worsening/new onset of headache associated with HFS, and dose of BoNT/A were examined. We diagnosed headache types according to The International Classification of Headache Disorders, 3rd edition, beta. Numerical Rating Scale (NRS) and Headache Impact Test-6 (HIT-6) scores for headache severity were compared between the 6-week baseline before BoNT/A therapy and 6-week follow-up after BoNT/A therapy. Results: Of 51 patients with HFS, 17 (33.3%) reported worsening or new onset of headache (especially TTH) associated with HFS (Group-S), and 34 were not aware of headache (Group-N). Twelve patients (70.6%) in group-S reported improvement of headache after BoNT/A therapy. NRS (from 7 [5–9] to 0 [0–5], p < 0.01) and HIT-6 (from 55 [54–64] to 44 [36–52], p < 0.001) scores were significantly improved after BoNT/A therapy. Logistic regression analysis revealed significant interaction between TTH associated with HFS and the presence of stress factors (odds ratio 43.11: 2.95–629.39, p < 0.001) and history of chronic headache (odds ratio 28.53: 2.96–275.10, p < 0.001). Conclusions: Primary headache, especially TTH, is associated with HFS. BoNT/A therapy for HFS may also be indirectly effective for treatment of TTH.