Dr. Levent Ünal
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Migraine Botox.

No. 1 Overview

Migraine Botox.

Migraine is not simply a severe headache. Sensitivity to light and sound, nausea, throbbing that worsens with movement and the fatigue that lingers for days after an attack all complete the picture. In people with headaches on many days each month, that cycle narrows work and social life considerably. Migraine botox is a supportive treatment considered in this group. Unlike cosmetic botox, the aim is not to soften lines but to reduce the excitability of the pathways carrying pain at defined points around the head and neck.

What the treatment targets

Botulinum toxin is distributed across defined points on the forehead, temples, back of the head, neck and upper shoulder. These points are not chosen at random; they are mapped to cover the muscle groups involved in headache and the areas where superficial nerves emerge. The treatment does not act immediately in the way a painkiller does; it is assessed over time, as support aimed at the frequency and severity of attacks.

Who it is considered for

It is considered for people diagnosed with chronic migraine who have headaches on many days each month and have not had enough benefit from their current medication. The diagnosis requires a neurology assessment. If the character of the headache has newly changed, if it began for the first time later in life, if neurological signs accompany it, or if it started suddenly and very severely, those pictures need investigating first. It is not used during pregnancy or breastfeeding, in certain neuromuscular conditions, or when there is an active infection in the area to be treated. Suitability is established together with your neurology follow up and a medical assessment.

How a session runs

The visit begins with a detailed headache history: how many days a month attacks occur, how long they last, which medications are in use and what the triggers are. If you have kept a headache diary, bringing it makes the assessment easier. The points across the head and neck are then identified and marked. The treatment is carried out seated, with fine needles, placing small volumes at each point. There are many points but each injection takes only moments. It is completed in an outpatient setting and does not require a hospital stay.

When the effect starts and how long it lasts

No effect is expected in the first days. Assessment is usually made over several weeks, and a fair judgement needs the number of headache days tracked month by month. The effect generally holds for a few months, with the repeat plan set according to how you respond. Where the expected change is not seen after a first treatment, the plan is reviewed. Results vary from person to person and no outcome can be promised.

Aftercare and what to watch for

  • Rest briefly afterwards and avoid heavy exertion the same day.
  • Do not massage the area in the first hours and keep away from heat.
  • A mild sense of tightness in the neck and back of the head for a few days is normal.
  • Do not stop medication prescribed by your neurologist on your own; any change is planned with your doctor.
  • Keeping a simple headache diary helps track attack frequency.

How follow up works

With this treatment, follow up matters as much as the treatment itself. You are asked to note the number of headache days, the severity of attacks and how often you reach for painkillers, in a simple notebook or on your phone. Without that record it is hard to read the change accurately, because migraine fluctuates month to month on its own. The records are compared at the next visit and the plan is reviewed against them. Keeping triggers in the same place, such as sleep patterns, skipped meals, caffeine and workload, makes it easier to tell what any change is actually down to. Your follow up with your neurologist continues uninterrupted throughout.

Points that are commonly confused

The first confusion is thinking migraine botox replaces a painkiller. It does not bring quick relief during an attack; it belongs to the preventive side of care. The second is assuming it is the same procedure as cosmetic botox. Point placement, distribution and purpose all differ, and although the forehead areas overlap, the planning is separate. The third is expecting it to take the place of neurology follow up. Migraine management works as a whole; sleep patterns, trigger identification and medication continue, with this treatment positioned as support alongside them.

No. 2 Process

The process step by step

From consultation to the review visit, every stage is planned in advance. An unhurried, transparent flow.

01

Assessment

How many days a month attacks occur, how long they last, which medications are in use and what the triggers are, are all discussed. The chronic migraine diagnosis and neurology follow up are handled together; bringing a headache diary makes the assessment easier.

02

Planning and prep

The defined points on the forehead, temples, back of the head, neck and upper shoulder are identified and marked. They are chosen to cover the muscle groups involved in headache.

03

Application

Small volumes are placed at each point with fine needles while you are seated. There are many points but each injection takes only moments. It is completed in an outpatient setting.

04

Aftercare and follow up

Rest briefly and avoid heavy exertion the same day. Do not stop medication prescribed by your neurologist on your own. The effect is assessed over several weeks, and tracking your headache days guides the plan.

No. 01 Is migraine botox different from cosmetic botox?

Yes. The aim is not to soften lines but to reduce the excitability of the pathways carrying pain at defined points around the head and neck. Point placement, distribution and dose planning all differ. Although the forehead areas overlap, the two treatments are planned separately.

No. 02 Who is it suitable for?

It is considered for people diagnosed with chronic migraine who have headaches on many days each month and have not had enough benefit from their current medication. The diagnosis requires a neurology assessment. If the character of the headache has newly changed or neurological signs accompany it, those pictures need investigating first.

No. 03 When is the effect seen?

No change is expected in the first days. Assessment is usually made over several weeks, and a fair judgement needs the number of headache days tracked month by month. The effect generally holds for a few months. Results vary from person to person and no outcome can be promised.

No. 04 Can it be used instead of a painkiller during an attack?

No. Migraine botox does not bring quick relief during an attack. It belongs to the preventive side of care, offered as support aimed at the frequency and severity of attacks. The plan your neurologist has set for treating attacks remains in place.

No. 05 Is the procedure painful?

The needle is very fine and small volumes are placed at each point. Because there are many points the treatment takes a few minutes, but each injection is very brief. A mild sense of tightness in the neck and back of the head for a few days afterwards is normal. If you feel uncomfortable, we can pause.

No. 06 Does it replace neurology follow up?

No. Migraine management works as a whole; sleep patterns, trigger identification and medication all continue, with this treatment positioned as support alongside them. It matters that you do not stop medication prescribed by your neurologist on your own; any change is planned together with your doctor.

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