Botox Not Just For Smoothing Wrinkles
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A drug best known for its ability to ease wrinkles in starlets and others is being used effectively by Trinity Health neurologist Bahram Kordlar, MD, to treat a variety of neurologic conditions.
Dr. Kordlar has long used Botox injection to treat such conditions as cervical dystonia, blepharospasm and hemifacial spasm. And now, following approval last year by the U.S. Food and Drug Administration, he's using Botox to ease headaches in adult patients who suffer from "chronic migraine".
"Chronic migraine is defined as a condition in which people have a migraine more than 15 days per month, lasting more than four hours a day," Dr. Kordlar explained. "It's one of the most disabling forms of headache, so it is important to have a variety of effective treatment options available."
Migraines are characterized by intense throbbing pain in one area of the head - often accompanied by nausea and sensitivity to light or sound. While most migraine sufferers experience migraines as an intermittent attack, some patients develop the more disabling chronic migraine.
So how can Botox help?
"Botox relaxes muscles and probably has an anti-inflammatory and analgesic effect," Dr. Kordlar explained. "It loosens up the muscles by preventing chemical release from traveling from the nerve endings to the muscle fiber, and in addition it prevents release of substances responsible for pain and inflammation."
During the treatment, Dr. Kordlar injects Botox into the forehead muscles, temporal muscles, and the muscles on the back of the head. More than one treatment may by required. But since Botox is high-priced compared to other remedies, it isn't the first therapy that Dr. Kordlar recommends for patients. There are less costly treatments available, including abortive therapies that attempt to stop a headache once it starts, and preventive treatments that often involve identifying and avoiding likely triggers, or taking a daily medication to prevent a headache from starting.
"If a patient doesn't respond to these therapies we can do a nerve block, which often helps. If not, then we look at Botox," Dr. Kordlar added. "Usually if we can break the cycle of the headaches it will be easier to control them. Sometimes we need to use preventative medications along with Botox injections. If Botox is effective it can last up to 8-12 weeks"
As noted, Dr. Kordlar has long used Botox to treat a variety of other neurological issues that are mostly characterized by involuntary muscle contractions affecting the eyes, face and neck. They include:
Cervical Dystonia - An abnormal head position and neck pain associated with neck muscles that contract involuntarily, causing awkward or abnormal posture of the head and neck.
Blepharospasm - The involuntary, forcible contraction of the muscles controlling eye blinks. The first symptoms may be increased blinking, and usually both eyes are affected. Spasms may cause the eyelids to close completely, causing "functional blindness" even though the eyes are healthy and vision is normal.
Hemifacial spasm (HFS) - An involuntary twitching or contraction of the facial muscles on one side of the face.
Dr. Kordlar is board certified in Neurology, providing general neurological care for patients dealing with the full spectrum of disorders and injuries affecting the central nervous system, peripheral nervous system and muscles. He is fellowship trained in sleep medicine and clinical neurophysiology. Dr. Kordlar's office is in Suite 303 of Health Center-East, 20 Burdick Expressway W., with appointments available at 857-5421.
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