(Botox) Mechanisms of Action in Altering the Molecular Environment in Which Pain Fibers Exist

Inclusion Criteria

• •Age 18-65 years
• •Diagnosis of Chronic Migraine consistent with International Classification of Headache Disorders (ICHD-III) criteria, with a history of bilateral headache pain and chronic tenderness in neck muscles
• •Patient is capable and willing to provide informed consent
• •Female subjects of child bearing potential must have a negative pregnancy test at enrollment and agree to remain abstinent or use acceptable methods of birth control (i.e., hormonal contraceptives, inrauterine device, diaphragm with spermicide, cervical cap or sponge, condoms or partner has had a vasectomy) for three months following injections of Botox
• •Patients referred by their primary Neurologist to the study surgeon and who are determined to be candidates for surgical decompression of extracranial sensory nerves.
• •Patient agrees to abstain from protocol-specific excluded medications beginning 14 days prior to the decompression surgery.