[Prophylaxis of chronic daily headache with a simplified regimen of subcutaneous administration of botulinum toxin type A].
Primary headaches are one of the most prevalent conditions in neurology. Botulinum toxin type A (TBA) has been used for years as a prophylactic measure for chronic daily headache (CDH) with varying infiltration regimens and outcomes. To demonstrate the speed, convenience and safety of a subcutaneous regimen of TBA as a prophylactic for CDH, and also to determine how effective it is as a preventive therapy. A total of 843 patients were infiltrated subcutaneously with 100 U of TBA (Botox) using a 'fixed dose-fixed site' technique in six pericranial points in periods of at least three months. We evaluated the reduction in the mean frequency of crises and days with headaches and the intake of analgesics, as well as the percentage of patients with a reduction of over 50% in the mean frequency of headache crises. Subcutaneous infiltration of TBA brought about a reduction of 78.91+/-6.81% in the frequency of monthly crises (p<0.001) and a reduction of 62.38+/-12.8% in the number of days per month with headache after three months' infiltration. Reports from patients indicated that 92.8% of them had reduced the number of days with headache per month by at least 50%. Mean frequency and total intake of analgesics decreased from 21.48+/-2.47 to 1.96+/-1.27 (p<0.001) and from 126.01+/-24.7 to 6.65+/-2.27 doses, respectively. There were few side effects, none of which were severe. Simplified subcutaneous infiltration of TBA is very effective, convenient, fast and safe as a means of preventing CDH.