OnabotulinumtoxinA in Migraine and Other Headaches: Review and Update

  • Marc E. LenaertsEmail author
  • Tiffany H. Green
Headache (JR Couch, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Headache


Purpose of the review

The role of onabotulinumtoxinA in headache management was serendipitously found over a decade ago and approved for chronic migraine in 2010 based on pivotal studies. The purpose of this review is to highlight the impact on headache and other health parameters which is critically reviewed, as well as the putative mechanisms of action.

Recent findings

OnabotulinumtoxinA is effective in migraine, not only headache frequency and pain intensity but also other health parameters including quality of life. Tolerability is high and benefit/cost analysis is favorable. It should be considered off-label in refractory trigeminal neuralgia and post-herpetic neuralgia but further research in these areas. Ongoing investigation of onabotulinumtoxinA in cluster headache is too preliminary for recommendation of use but promising. Recent and future developments in other headache disorders are discussed.


OnabotulinumtoxinA has been approved for migraine almost a decade ago and been proven beneficial not only on headache parameters but other health outcomes. Its role as adjuvant is being studied and emerging in other headache syndromes.


OnabotulinumtoxinA Headache Migraine Cluster headache Trigeminal neuralgia 


Compliance with Ethical Standards

Conflict of Interest

Marc Lenaerts is a member of Speakers Bureaus of Amgen, Allergan, and Teva Pharmaceuticals. Tiffany Green declares no potential conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologyUniversity of CaliforniaSacramentoUSA

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