10:08 AM EDT on Friday, May 12, 2006

Reported by: Kathryn Barrett

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The same Botox that zaps away wrinkles can manhandle a migraine.

Shelly Sneed has suffered from migraines for about 30 years -- since she was 22. They're not just horrible headaches, they're knock-you-out migraines.

"Just a piercing pain. You feel like somebody put a icepick right above my left eye," she explained.

The pain radiates around her scalp and down her neck and often makes her nauseous.

Botox used as a preventive can reduce the pain of migraine similar to the way it reduces wrinkles.

In this case, Botox doesn't paralyze the muscle but weakens it and stops nerve endings from passing on the pain.

Scientists don't know exactly how it works.

"The theory is that by reducing the release of those inflammatory chemicals from the nerve endings, it reduces the pain of headaches," said Dr. Neil Pugach, a Hampton Roads neurologist.

So far, small studies and patients themselves report that Botox helps migraines.

It's been a long time, about ten years, since women first noticed their migraines improved after botox injections for facial wrinkles.

Botox still isn't FDA approved to treat migraines.

Doctor Pugach is involved in a study he hopes will change that.

"What's going on now is a large North American trial where many people are receiving either Botox or a placebo for chronic migraines and, hopefully within a year or two, we'll have very good data hopefully proving actually that it works," he said.

With proof, health insurance might cover the cost. Most companies don't and it's not cheap.

Shelley's treatment costs about $1,500 and since Botox is temporary, she is treated every three months.

"I was approved for one year as just a trial, and after that one year, they said, 'Since you weren't cured, we're not gonna pay for it anymore,'" said Sneed, who is a doctor herself.

She says Botox is the best treatment she's tried for her migraines.

"They're not as severe. I don't have 'em as often and they don't last as long since I started the Botox."

The so-called "preempt" trial of Botox versus placebo is underway now.

To enroll in the Botox-Migraine trials, contact Dr. Pugach at:

Brighton Research Group

Neil Pugach, MD

780 Lynnhaven Parkway, Suite 285

Virginia Beach, VA 23452

757-368-0672