What is Chronic Migraine?

Chronic Migraine is a debilitating condition that affects up to 65,000 New Zealanders (using a prevalence rate of 1.3% as quoted by an international expert, Dr Sheena Aurora, Neurologist, Seattle, USA during her presentation on Chronic Migraine for Australasian experts).  Chronic Migraine is defined as having severe headaches for more than 4 hours per day, for more than 15 days out of 30, with more than 8 episodes in the last 3 months or a previous diagnosis of migraines, that are either throbbing/moderate to severe which can be unilateral and aggravated by normal physical activity with either nausea and/or vomiting or photophobia and phonophobia, which is not attributed to another causative disorder (Classification accepted by ICHD-2 International Classification of Headache Disorders 2nd Edition).

 

Dr Wong views migraines as a sensory hypersensitivity disorder, not just severe headaches.  It is important to ask yourself, what was going on in your life at the time of the very first headache?

 

What can I expect?

So long as you fulfil the screening requirements, which means that you are likely to benefit from the procedure, then you can arrange for an initial consultation with Dr Wong.  If treatment with Botox® is considered the best option for you, then a personally tailored treatment plan is made. It is important that all patients have a realistic expectation. The definition of success as accepted by neurologist worldwide, is a reduction in the number of migrainous headaches or a reduction in the severity of the headaches by at least 50%. Evidence from clinical studies show with repeated doses of Botox® over a period of one year can expect over 70% of patients will see a 50% improvement in their symptoms.  All severe chronic migraine sufferers are encouraged to have intensive physiotherapy which will further improve their outcome.

 

Will my wrinkles go away?

This depends on where you need the Botox®. Often patients who come in wanting their frown lines or forehead lines treated with Botox® may find the treatment initially can cause a brief headache that responds to taking Panadol®. Within a few hours to a few days, some patients can notice their migraines are also better.

 

This can also be seen in patients who suffer from bruxism or teeth grinding.  Botox® into this region can often relieve tension headaches.

 

Is there any guarantee it will work?

Unfortunately not. It pays to approach this with a completely open mind. Remember, before you consider using Botox® for your chronic migraines, make sure you have tried all the conventional treatments first.

 

The PREEMPT Study (Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy), a randomised clinical trial has demonstrated clinically significant improvement in the reduction of headaches and migraines in over 70% of patients (defined as a reduction of more 50% of your baseline headaches or migraines prior to treatment) using Botox®.  Botox® for chronic migraine at Auckland Cosmetic Medicine Clinic Limited - Sapphire Chronic Migraine Clinic combined with effective physiotherapy has produced results superior to those published, with over 90% improvement for our patients (unpublished data).  

 

If you have been diagnosed by your doctor as having migraines, and you have headaches lasting more than four hours each day, affecting you more than 15 days each month, then click this link for an online booking stating you would like to book for a consultation at the Migraine Clinic with Dr Garsing Wong at Auckland Cosmetic Medicine Clinic Ltd - Sapphire Appearance Medicine Clinic, located not far from Victoria Park Market, bordering Freemans Bay, Ponsonby and St Mary's Bay. Please note the initial consultation fee of $300 is applicable with all initial migraine related consultations.

 

What is the cost of the treatment?

If you fulfill the criteria of being a chronic migraine sufferer, and you have tried prophylatic (preventative) medications, as well as had either an assessment with a neurologist for your migraines or you have had brain imaging in the past, or you have been referred by your general practitioner, then a treatment program to treat your chronic migraine with Botox® quote will be given at the time of your consultation.  The treatment program for Chronic Migraine is for 1 year, after which your situation would be reevaluated.  This does not include Dr Wong's consultation fee and the cost of physiotherapy.  At present, the cost for the treatment are not reimbursed by your medical insurance company.

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Can the Botox for Chronic Migraine treatment be combined with other Migraine Medications?

The short answer is YES.  However a detailed assessment with Dr Wong is required to see if this is suitable and appropriate.

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BOTOX® is a Prescription Medicine containing 100 units of botulinum toxin type A or Onabotulinumtoxin A for injection (Please note, in America, the generic name for Botox® is onabotulinumtoxin A which is exactly the same.(refer to the FDA Press Release dated August 3, 2009). It is used for the treatment of frown lines. It should be administered only by trained medical professionals. Talk to your specialist about the benefits/risks of this procedure in appearance medicine. Cautions: People with defective neuro-muscular transmission disorders, infection at site of injection, glaucoma, pregnancy and lactation. Possible side effects include headaches, pain, burning or redness at injection site, local muscle weakness including drooping eyelids, lack of feeling and nausea. If you have any side effects or concerns speak to your doctor. You will need to pay for this medicine. Normal doctors visits apply. Note: The treatment lasts about four months and after this time further courses of treatment may be necessary. Speak to your doctor about your own situation.

 

BOTOX® is a registered trademark of Allergan Inc.

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Aquipta® is a Prescription Medicine containing Atogepant tablets. It is used to prevent migraine in patients who have at least 4 migraine days per month. It is an unfunded medicine available with a valid prescription. Aquipta® is a tablet that is taken once a day with few side effects. Talk to your specialist about the benefits/risks of this medication. Cautions: Do not take Aquipta® if you are allergic to atogepant or any of the other ingredients of Aquipta®. Aquipta® is not recommended during pregnancy.  Aquipta® is unlikely to a have an effect on your ability to drive and use machines. Possible side effects include nausea, constipation, decreased appetite, tiredness, drowsiness. If you have any side effects or concerns speak to your doctor. You will need to pay for this medicine. Normal doctors fees for every visits apply. 

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Emgality® is a Prescription Medicine containing Galcanezumab 120mg injection. It is used to treat migraines and prevent cluster headaches.  It is an unfunded medicine available with a valid prescription. Emgality® comes as taken as a prefilled pen once a month. Talk to your specialist about the benefits/risks of this medication. Cautions: Do not take Emgality® if you are allergic to Galcanezumab or any of the other ingredients in Emgality®.  It is not recommended during pregnancy.  Emgality® is unlikely to a have an effect on your ability to drive and use machines. Possible side effects include injection site reactions, rash, allergic reaction, high blood pressure, Raynaud's phenomenon, nausea, constipation, decreased appetite, tiredness, drowsiness. If you have any side effects or concerns speak to your doctor. You will need to pay for this medicine. Normal doctors fees for every visits apply. 

 

*The first treatment cost may change at any time, and you will be informed at the time of making your appointment if there has been any variation in price.  Initial consultation fee applies, and followup consultation fee are not included in the cost of the treatment.

 

Updated 3rd August 2025