A Mayo Clinic case study has found that Botox may offer new hope to patients suffering disabling low cerebrospinal fluid (CSF) headaches. The successful treatment also offers new insight into Botox and headache treatment generally. The case study was presented on 13 March 2011 at the American Academy of Neurology meeting in Hawaii.
Low CSF pressure headaches are caused by an internal spinal fluid leak. The pain can range from slight to disabling. The headaches are most commonly triggered by a lumbar puncture. The pain is caused as fluid leaks out and the brain sags. For many patients, lying down has offered the only relief, because existing therapies were not fully effective. Traditional treatment is a blood patch, which is just that: a patch of the patient’s blood injected over the puncture hole.
The patient in the case study suffered low CSF pressure headaches for 25 years. For most of that time, she only felt better while lying down, curtailing her day-to-day activities. Five years ago, she sought help. The patient has received Botox for 3 years and the results have been consistently positive. After each treatment, improvement would last for 3 months before pain returned, requiring another dose. While not cured, the patient is now able to live a more normal life.