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A Proposal to Prevent the "Mephisto Sign" Side Effect of Botulinum Toxin Type A Injection in Chronic Migraine

Authors
 Eunae S. Cho  ;  Jae Young Hwang  ;  Seong Taek Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.54(6) : 1542-1544, 2013 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2013
MeSH
Adult ; Botulinum Toxins, Type A/administration & dosage ; Botulinum Toxins, Type A/adverse effects* ; Female ; Humans ; Injections ; Migraine Disorders/drug therapy*
Keywords
Migraine disorders ; botulinum toxin type A ; eyebrows
Abstract
Botulinum toxin type A (BoNT-A) has been reported as an effective treatment for chronic migraine. When BoNT-A is injected on the frontalis muscle for chronic migraine, an unexpected clinical side effect called the "Mephisto sign" may occur. The aim of this article is to propose a method to eliminate or prevent the Mephisto sign side effect. A 25-year-old female patient visited the hospital and was diagnosed with chronic migraine. A total of 155 U of BoNT-A was injected into 31 sites. 2-weeks later, and the patient developed the Mephisto sign. An additional 2-U dose was administered bilaterally to the lateral-most point of the frontalis muscles, and the eyebrow morphology returned to normal within 2-3 weeks. We propose that the development of the Mephisto sign may be prevented with an additional BoNT-A injection of 2-4 U bilaterally to the lateral most point of the frontalis muscles during the primary injection process.
Files in This Item:
T201303441.pdf Download
DOI
10.3349/ymj.2013.54.6.1542
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seong Taek(김성택)
Cho, Eunae(조은애산드라) ORCID logo https://orcid.org/0000-0002-0820-3019
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88078
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