Retrospective Review Investigating the Efficacy of the Gray/Campbell Migraine Injection Protocol for OnabotulinumtoxinA (A Modified PREEMPT Injection Paradigm for Chronic Migraine Treatment)

Chronic migraine is a potentially debilitating condition that can be detrimental to someone’s quality of life. Clinical data has proven OnabotulinumtoxinA (BoNT-A) to be an effective prophylactic treatment for chronic headache types, and it is now regularly employed by headache treatment centers. The PREEMPT injection protocol has become the standard treatment regimen surrounding Botox injections for chronic migraine treatment since it was granted approval by the FDA in 2010. This retrospective chart review of patients treated for chronic migraine at Maine Comprehensive Pain Management in Scarborough, Maine, presents an alteration to the standard PREEMPT injection paradigm that reinforces the efficacy of Botox for chronic migraine treatment. We will discuss our Modified PREEMPT injection paradigm, which yields a positive clinical response rate of 95% of patients achieving at least 50% improvement in their migraine headaches. This appears to be the highest established response rate in the literature to date.