Botulinum toxins play a very significant part in the management of a wide variety of medical conditions, primarily hemifacial spasm, spastic movement disorders like hypersalivation, hyperhidrosis and strabismus and focal dystonias. In this review by Mimeh H et al., London Aesthetic Migraine Protocol (LAMP) was constructed using the PREEMPT injection site and is safe, evidence-based guidance for the trained and experienced aesthetic practitioner to manage CM in their aesthetic clinics.

Migraine is regarded as the 6th highest reason for disability worldwide by the World Health Organization. Physical and mental health, functionality and QoL (quality of life) of migraine patients are severely affected. The economic burden of migraine on the is approximately £3.42 billion yearly on the UK  economy. In the present study, an evidence-based literature review was conducted to establish the safety and effectiveness of botulinum toxin type A (onaBoNTA) in patients suffering from chronic migraine (CM) in comparison to placebo. Based on the identification of the best evidence, the protocol will be formulated for better management of CM by the physicians in their aesthetic clinic.

On March 1, 2018, Pubmed MEDLINE electronic database was used to carry out the comprehensive search of the current literature. The articles published till and inclusive of March 1 2018 were incorporated in the study.re incorporated. Articles in English language and those related to human studies were included. Animal and in-vitro studies were not considered for inclusion.

Two hundred sixty articles were identified but only the high-strength (Level 1A) and excellent-quality trials were considered to find the unmet need.

High quality level 1A evidence supports the safety and tolerance of Botulinum toxin type A in treating patients with CM. Also, there is high risk of adverse effects and some uncertainty regarding the extent to which Botulinum toxin type A may benefit migraine patients in comparison to placebo. This data has been used to construct The London Aesthetic Migraine Protocol (LAMP). The evidence based results from this study will aid in the better management of CM by the trained and experienced aesthetic practitioners.