Adults

Pediatric Migraine > 14 years

• Migraine (with or without aura)

• Chronic migraine

• Tension-type headache

• Cluster headache and trigeminal autonomic cephalalgias

• Medication overuse headache

• Post-traumatic headache and concussion-related headache

• New persistent daily headache

• Secondary headaches requiring neurological evaluation

• Preventive medications for migraine and chronic headache disorders

• Acute migraine therapies including triptans

• CGRP-targeted therapies formigraine treatment

• Botulinum toxin (Botox) injections for chronic migraine

• Occipital nerve blocks and other peripheral nerve blocks

• Infusion-based therapies for severe or refractory migraine

• Lifestyle and trigger management strategies

Botulinum toxin (Botox) is an established treatment option for patients with chronic migraine, defined as headaches occurring on 15 or more days per month for at least three months, with migraine features on many of those days. Botox works by blocking the release of certain pain-related chemicals from nerve endings and reducing the sensitivity of pain pathways involved in migraine.

The treatment involves a series of small injections administered into specific muscles of the head and neck. The procedure is performed in the clinic and typically takes about 10–15 minutes. Treatments are generally repeated every 12 weeks as part of a long-term migraine prevention strategy.

Clinical studies have shown that Botox can significantly reduce the frequency and severity of migraine headaches, improve daily functioning, and decrease reliance on acute migraine medications. Many patients begin to notice improvement after the first or second treatment cycle.

Botox for chronic migraine is approved by Health Canada and is commonly used when patients continue to experience frequent migraines despite trying preventive medications.

Patients are assessed by a neurologist to determine whether Botox is an appropriate treatment option as part of a comprehensive migraine management plan.

Anti-CGRP (Calcitonin Gene-Related Peptide) therapies are a newer class of medications developed specifically for the prevention and treatment of migraine. CGRP is a neuropeptide involved in migraine pathways that contributes to inflammation, pain transmission, and dilation of blood vessels in the brain. These medications work by blocking the CGRP pathway, helping reduce the frequency and severity of migraine attacks.

Anti-CGRP therapies are used for patients who experience frequent or disabling migraines, particularly when traditional preventive medications have not been effective or are not well tolerated.

Several forms of anti-CGRP therapy are available. Some medications are given as monthly or quarterly injections for migraine prevention, while others are taken orally for the acute treatment of migraine attacks.

Clinical studies have shown that anti-CGRP treatments can significantly reduce migraine days per month, decrease headache severity, and improve quality of life. These therapies are generally well tolerated and are designed specifically to target migraine mechanisms.

A neurologist will assess whether anti-CGRP therapy is appropriate based on migraine frequency, prior treatments, and overall clinical history as part of a comprehensive migraine management plan.