Effects of onabotulinumtoxin A in patients concurrently diagnosed with chronic migraine encephalalgia and temporomandibular disorders: A retrospective case series

Cranio. 2022 Mar 14:1-11. doi: 10.1080/08869634.2022.2045114. Online ahead of print.

Abstract

Objective: Chronic migraine encephalalgia (CME) with concomitant temporomandibular disorder (TMD) is a serious illness with limited effective treatment options. This study explores the effectiveness of onabotulinumtoxinA (BtxA) as an adjunct therapeutic to TMJ arthroscopy in the relief of CME.

Methods: A retrospective cohort study of patients receiving TMJ arthroscopy, with or without BtxA injections for CME, was conducted. Variables assessed include pain using a visual analog scale (VAS), maximal incisal opening (MIO), muscle soreness, and headache frequency and duration.

Results: Sixty patients (44 BtxA, 16 Control), consisting of 56 (93.3%) females, met inclusion criteria. A significant reduction in pain is reported with patients receiving BtxA (p < 0.0001) on VAS as compared to Control group. BtxA treatment also significantly reduced headache frequency and duration (p < 0.05).

Conclusion: These results support the use of adjunctive BtxA treatment with arthroscopy for the treatment of CME in the context of TMD.

Keywords: OnabotulinumtoxinA; arthroscopy; chronic migraine; headache; pain; temporomandibular disorder.