Effect of COVID-19 Vaccination on Management of Chronic Migraine with Botulinum Toxin: A Case Series

Abstract

Introduction: Headache worsening has been previously reported following the coronavirus disease 2019 (COVID-19) vaccination. However, COVID vaccination's influence on managing chronic migraine (CM) with botulinum toxin is yet to be studied. Case Presentation: In this case series, we present five cases of CM, who had responded to abobotulinum toxin type A (BTX-A), but their number of headache days increased after COVID vaccination. Conclusions: In the case of vaccination with COVID vaccines, during the first month of administering botulinum toxin for the management of CM, there might be a decrease in the efficacy of botulinum toxin, which should be explained to the patients. The authors suggest that physicians postpone the administration of BTX-A for chronic migraine management to a later time at their discretion.