Abstract Details

Title Onabotulium Toxin Type A (Botox@) in the Treatment of Chronic Post Traumatic Headache Related to Sports Concussion: A Case Report

Topic Sports Neurology

Presentation(s) IN5 - (-)

Poster/Presentation
Number 009

Objective

Background Headache is the most common and often the most prolonged symptom of sports related concussion. In athletes with prolonged concussion symptoms chronic post traumatic migraine headache is usually the most prevalent and disabling symptom. There are very few studies relating to the treatment of headache in athletes who have sustained concussion. Onabotulinum Toxin Type A is the only FDA approved medication for the treatment of Chronic Migraine. Studies have suggested and it has been hypothesized that Chronic Post Traumatic Migraine and Chronic Migraine share similar if not identical pathophysiology.

Design/Methods This is a case report of a 15 year old WM with a history of chronic post traumatic migraine headache triggered by sports related concussion. The patient was injected with Onabotulinum Toxin Type A using a modified Chronic Migraine Protocol developed by Allergan. Primary outcome was the decrease in the number of headache days. Secondary outcomes included: Decrease in headache severity as rated on a ten point visual analog scale. Decrease in abortive medication use. Decrease in associated concussion symptoms.

Results The patient experienced complete resolution of his chronic post traumatic headaches and complete resolution of his concussion symptoms after treatment with Onabotulinum Toxin Type A.

Conclusions Onabotulinum Toxin Type A may be an effective treatment in very carefully selected concussed athletes with prolonged headache symptoms. Further research into proper patient selection, long term outcome, return to play and risk of future concussion are needed.

Authors/Disclosures
Francis X. Conidi, DO, MS, FAHS FAAN, FAAN (Florida Center for Headache and Sports Neurology) PRESENTER	No disclosure on file
Bahman Jabbari, MD, FAAN	No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp 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. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.

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