For the past three or four years dermatologists and neurologists have been successfully treating migraine headaches with Botox in selected patients and this past week the FDA finally approved the use of Botox for migraine patients. That is really great news for the millions of migraine sufferers out there. Since we think that migraines are caused by a squeezing or spasm or contraction of blood vessels either in the face or head, Botox probably works either by paralyzing the muscles that those blood vessels go through so they can’t squeeze those vessels or perhaps even by neutralizing and paralyzing the muscles in the blood vessels so they can’t contract or go into spasm. But here’s the catch. The place where the migraine starts is called a trigger point and the trigger point is where you really have to get the Botox in order to get relief from your migraines. Well that means that your trigger point has to be in a treatable location. Because Botox paralyzes muscles, your trigger point can’t be someplace where the muscle is important and useful, like the muscle in the middle of your cheek, you won’t be able to smile, or the muscle in the back of your neck, you won’t be able to hold your head up. This is the bottom line: if you’re a migraine sufferer or if you think you suffer from migraines, see a neurologist to find out if you’re a candidate for relief from your migraine headaches with Botox therapy.