Evaluation of the effect of botulinum neurotoxin type A (BoNT/A) application on daily life activities in patients with chronic migraine with VAS, MIDAS and HIT-6 tests

Chronic migraine which has seen in %1.3-2.4 of the community is a disease affecting the performance of both business and private life. According to the ICHD-II 2006criteria chronic migraine has been defined as headache emerging more than 15 days in month, longer than 3 months without excessive use of drugs, and can not be attributed to another disorder, of which at least of 8 that carries migrainous characteristicsor with migraine-specific treatment response and in the requirement of having 5 or more migraine attacks previously. The purpose of this thesis to evaluate the impact of application of Botulinum Neurotoxin type A (BoNT / A) with VAS, MIDAS and HIT-6 tests to patients diagnosed with chronic migraine to their daily activities 25 patients who applied to the neurology clinic of Celal Bayar University School of Medicine, diagnosed with migraine, not benefit from the specific prophylactic treatment of migraine used with appropriate period andthe dose, diagnosed with chronic migraine according to II 2006 criteria of International Headache Society of ICHD, and botulinum neurotoxin application has been made were retrospectively evaluated between September 2012 and May 2014. VAS, MIDAS and HIT-6 test results which determines the severity of headache and activities of daily living after the first and second botulinium toxin application from the files of these patientswere evaluated retrospectively.MIDAS (Migraine-associated loss assessment scale), VAS (visual analogue pain scale) and HIT-6 tests were performed to all patients included in the study before initiating the therapy.155 BoNT / A injection was made to the patients appropriate with the protocol of PREEMPT twice at 12-week intervals. VAS, MIDAS and HIT-6 test results of patients were determined after each injection. Patients were monitored once at 12 weeks for the control and application. Test results of patients during admission were compared with the results of first and second applications. During this period, patients were followed by headache diary. VAS, MIDAS and HIT-6 values were compared during admission and after first and second applications, and in the result of this comparison, a significant reduction has been observed in VAS, MIDAS and HIT-6 values, and this difference was statistically significant (P <0.05). Correlation study has been made between this scales and a significant correlation is revealed between this 3 tests. The averages of monthly migraine days with headache in 3 months period prior to application and the averages of monthly migraine days with headache in 3 months period after first and second application are compared one by one with eachother and a significant correlation is found between this values (p=0,000). The results of our study has shown that BoNT/A is an effective and safe treatment option for chronic migraine prophylaxis similar to the resutls of earlier studies. Therefore, BoNT/A should be considered as an important and effective option in the cases of a diagnosed with chronic migraine which not respond to the specific prophylactic treatment and affect the activities of daily life due to pain frequency and severity.