Abstract Details

Title Safety of Onabotulinum Toxin A for the Treatment of Chronic Post-Traumatic Headache in Service Members with a History of Mild Traumatic Brain Injury

Topic Headache

Presentation(s) P01 - (-)

Poster/Presentation
Number 076

Objective

Background Headache is a common complication of mild traumatic brain injury (mTBI) in active duty service members. Migraine and chronic migraine type are most common. The approved use of OBA in chronic migraine (CM) led us to hypothesize that OBA might be safe and possibly effective in secondary headaches with features of CM.

Design/Methods This is a retrospective consecutive case series of patients treated with OBA for PTH in the Concussion Care Clinic at Womack Army Medical Center, Ft. Bragg, NC between 8/2008 - 8/2012. Patient demographics, prior history of headache, injury type, current headache type, time from injury to first injection, treatment techniques, number of treatments/treatment interval, side effects, reasons for discontinuation and Patient Global Evaluation of Change (PGEC) are reported.

Results 67 (66 male; mean age 31.1 + 7.7) were treated, 10% with history of headache. Most common injuries: blast (46.3%), parachute jumps (14.9%) and motor vehicle accidents (11.9%). 56.7% reported more than one headache type. Headache types included: Chronic migraine (CM) (22.4%), episodic migraine (EM) (7.5%), chronic tension type (CTTH) (7.5%), Hemicrania Continua (7.5%), nummular (1.5%); mixed CTTH/CM 28/67 (41.8%); and CTTH/EM (7.5%). 74.6% had continuous headache. Mean time to first injections: 30 + 22.9 months (1 - 120); mean treatments: 3.2 + 3.8 (1 - 19). 62.3% were treated by FSFD. Reasons for discontinuation included ineffectiveness (44.8%), side effects (2.9%), or reinjury (1.5%). 22.4% were lost to follow-up of whom 73.3% reported being "much better". Overall, 59.7% were better/much better, 4.5% were worse/much worse; 32.8% reported no change.

Conclusions OBA appears to be safe and well tolerated in active duty service members treated for PTH, warranting further studies of efficacy and consistency of effect.

Authors/Disclosures
Juanita A. Yerry, PA PRESENTER	No disclosure on file
Steven Lewis, MD (First Health of the Carolinas - Moore Regional Hospital)	No disclosure on file
Alan G. Finkel, MD, FAHS, FAAN (Carolina Headache Institute)	Dr. Finkel has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Carolina Headache Foundation. Dr. Finkel has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various.
Gavin Giovannoni, MD (QMUL)	Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.

��ɫ��

��ɫ��