Dr. Michael Cutrer of the Mayo Clinic in Rochester, Minn., says pain can range from slight to disabling from low cerebrospinal fluid pressure headaches, caused by an internal spinal fluid leak. The headaches are most commonly triggered by a lumbar puncture and the pain is caused as fluid leaks out and the brain sags, Cutrer says.
For many patients, lying down has offered the only relief and treatment is a blood patch, which is a patch of the patient's blood injected over the puncture hole.
The patient in the case study suffered low cerebrospinal fluid pressure headaches for 25 years. For most of that time, she only felt better while lying down, curtailing her activities significantly.
However, five years ago, she sought help from Cutrer and Dr. Paul Mathew and she received Botox for three years as treatment.
The doctors said the results have been consistently positive. After each Botox treatment, improvement would last for three months before pain returned, requiring another dose, the case study says.
"We had been using Botox for several years for treatment of migraine and had been successful in many patients. And because we really didn't have anything else to offer her, we gave her the Botox," Cutrer says in a statement.
The case study was presented at the presented at the American Academy of Neurology meeting in Hawaii.