EHMTI-0326. OnabotulinumtoxinA for the treatment of chronic paroxysmal hemicrania: a case report

  • D Dolezil
Open Access
Meeting abstract


Internal Medicine Migraine Total Dose Injection Site International Classification 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Chronic paroxysmal hemicrania (CPH) is characterized by attacks of very severe, unilateral pain, fulfilling criteria of The International Classification of Headache Disorders, 3rd edition, beta version ( ICHD-3 beta) for paroxysmal hemicrania and occurring without a remission period, or with remissions lasting <1 month, for at least 1 year.


OnabotulinumtoxinA is now used for the treatment of chronic migraine.We wanted to try the treatment of CPH with OnabotulinumtoxinA, because other treatments have not been effective.

Patient and methods

We present the case of a patient diagnosed with CPH that lasts for 32 years. Attacks of headache lasted about 15 years without remission. The patient described her headaches as attacks of hemicrania lasted from 15 to 25 minutes with a frequency usually 8 times per day. OnabotulinumtoxinA was infiltrated at eight ipsilateral points. Total dose was 45 units (each intramuscular injection site was 0.1 mL = 5 U onabotulinumtoxinA). Seven points were identical as in the treatment of chronic migraine in the frontal and temporal areas and one point was in infraorbital area.Method applications of onabotulinumtoxinA based on the methodology of application of onabotulinumtoxinA in patients with chronic migraine.


The CPH showed a dramatic response to onabotulinumtoxinA infiltration. Effect of treatment was evident as early as three weeks after the first injection, gradually improved, it takes seven months from start of treatment with 3-monthly infiltrations.


The treatment of CPH with OnabotulinumtoxinA significantly improved the quality of life of the patient.

Copyright information

© Dolezil; licensee Springer. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • D Dolezil
    • 1
  1. 1.Prague Headache Center, DADO MEDICAL s.r.o.Prague 2Czech Republic

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