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Botox provides treatment option for chronic migraines


A migraine is a headache that can cause severe pain and be accompanied by nausea, vomiting, an extreme sensitivity to light and sound. Individuals who suffer from migraines can be affected for hours to days at a time and can experience interruptions in daily activities. Medications are available to prevent migraines or make them less painful. Botox injections are one option that Community HealthCare System can offer to patients who meet certain criteria.

Dr. Kendra Reith recently took time to answer a few questions about how Botox can help. 

What kind of patients could benefit from Botox?

Botox injections are a great option for patients suffering from chronic migraines to consider if they have failed to get good relief from daily preventative migraine medications. To qualify for Botox injections, patients must try two classes of preventative medications and fail to receive adequate relief.

Why are you excited to offer Botox?

I have cared for many migraine patients who felt like they were out of options to treat their headaches. Chronic uncontrolled migraines can have a significant impact on quality of life, and brain imaging done on patients with chronic migraines shows that repeated migraines actually cause structural changes in the brain! Sometimes these patients find themselves in the ER frequently needing migraine cocktails, and often they have to miss work and/or family events due to their symptoms. For some of these patients, Botox has literally been life-changing because it allows them to be able to participate in normal activities. I am always excited to hear a patient tell me that they finally have relief from their migraines and that they are able to enjoy life again. 

What kind of visits does this require? Does it have to be done at certain intervals?

The first visit is a consultation with me to discuss headache history and the procedure itself. We will discuss a patient's headaches in depth as well as medications that have been tried in the past to make sure they are a good candidate for Botox. If we determine that Botox would be a good option, we can then schedule the first round of injections.

The procedure itself is done here in the clinic and involves injections given in specific places on the forehead, scalp, and shoulders. This procedure is not "one and done"--it must be repeated to reach the full therapeutic effect. If a patient notes improvement and discontinues injections, then their symptoms are likely to return. It can sometimes take 3-4 cycles to begin to notice improvements in migraine symptoms. Injections are repeated every 84-90 days as long as a patient continues to feel it is beneficial

What do people need to know about the treatment?

Botox is generally very well tolerated by patients. Immediate effects at the time of injection may include mild swelling or bruising at the injection sites, as can happen with any type of injection. Botox has a paralytic effect on muscles, so there is a small risk of eyebrow/eyelid drooping, which is more likely to happen if the Botox goes somewhere it shouldn't; I always counsel patients about how to help prevent this. If a patient has a personal history of a motor neuron disease (such as ALS) or a history of neuromuscular disorders (such as myasthenia gravis or Lambert-Eaton syndrome), then Botox is contraindicated and can’t be administered. Botox injections also should not be performed when a patient is pregnant.

As with any medication, there is also a very small risk of possible allergy to the Botox itself, in which case this therapy would not be able to be administered.

Anything else you want to add?

If you struggle with severe headaches on a regular basis--even if you are not sure if they are migraines--please talk to your medical provider! Chronic migraine is a very under-diagnosed condition, and it is treatable.  

I am also trained to perform cosmetic Botox and dermal fillers. These services are not yet available, but I am hopeful that I can offer them soon!

Dr. Kendra Reith graduated from Kansas State University and the University of Kansas School of Medicine. She completed her residency at Smoky Hill Family Medicine in Salina and joined CHCS in January 2022. Dr. Reith is a native of Belleville, Kansas, and is happy to be practicing in a rural setting. She and her husband, Brent, live in Onaga with their young son, Brigham. 


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