Silberstein S D
Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Expert Opin Pharmacother. 2001 Oct;2(10):1649-54. doi: 10.1517/14656566.2.10.1649.
Botulinum toxin type A (BTX-A) has been used successfully for many disorders related to excessive muscle contraction. It works, in part, by causing a dose-dependent, reversible muscle relaxation. BTX-A has also been used for migraine prevention. The mechanism by which BTX-A acts in migraine is probably unrelated to its effect on muscle relaxation. BTX-A may have a distinct antinociceptive mechanism, either through action on the muscle spindles or through a direct effect on the central nervous system. Several trials and case reports have demonstrated the safety and efficacy of BTX-A in migraine headache. BTX-A is distinct from other preventive medications. Adverse events (AEs) are rare and mild. BTX-A is convenient, since the dosing interval may be 3 months or longer. However, before BTX-A can be considered a first-line agent for migraine, larger studies need to be conducted to determine optimum dosing and administration sites as well as patient characteristics that are predictive of response.
A型肉毒毒素（BTX-A）已成功用于许多与肌肉过度收缩相关的疾病。它部分通过引起剂量依赖性、可逆性肌肉松弛起作用。BTX-A也已用于偏头痛预防。BTX-A在偏头痛中起作用的机制可能与其对肌肉松弛的作用无关。BTX-A可能具有独特的抗伤害感受机制，要么通过作用于肌梭，要么通过对中枢神经系统的直接作用。多项试验和病例报告已证明BTX-A在偏头痛治疗中的安全性和有效性。BTX-A与其他预防性药物不同。不良事件（AE）罕见且轻微。BTX-A使用方便，因为给药间隔可以为3个月或更长时间。然而，在BTX-A可被视为偏头痛的一线药物之前，需要进行更大规模的研究，以确定最佳剂量、给药部位以及可预测反应的患者特征。
