(BPT) - There’s an invisible disease that affects 31 million Americans. Its symptoms are often debilitating and impact people in various aspects of their lives. The name? It’s called migraine disease.People living with migraine disease experience a wide spectrum of the disease, ranging from Episodic Migraine to Chronic Migraine. Because the pain related to migraine is often difficult to describe, it’s important to stay informed of the types of migraine, symptoms, triggers and potential treatment options, if you or someone you know may be living with migraine.What are the most common types of migraine?Migraine disease is defined as a neurovascular disease of the brain, characterized by intermittent headache attacks with a number of neurological symptoms that are often severe enough to be incapacitating. It is also a spectrum disease, which means that people with migraine can move through episodic and chronic stages, as well as remission.Episodic Migraine (EM) is characterized by 14 or fewer headache days per month (with some of them as migraine days) with relatively less frequency, sometimes ranging from weeks or months between migraine attacks.While many people experience occasional headaches or EM, those who experience 15 or more headache and migraine days a month (each headache lasting four or more hours) may be living with Chronic Migraine (CM). Impacting 3.3 million Americans, Chronic Migraine is a distinct disease that can be debilitating and often misunderstood.What are the symptoms of a migraine attack?People living with Chronic Migraine can experience a wide range of symptoms, from throbbing pain at the side or front of the head, often with nausea or vomiting, and increased sensitivity to light and sound, among others. During a migraine attack, people experience multiple phases and various symptoms related to each phase, including aura and a post-migraine “hangover” phase. Symptoms may include neck pain, mood changes, sensitivity to light or sound, fatigue, numbness and difficulty producing or understanding words, among other symptoms.What are some potential causes and triggers of Chronic Migraine?Although there hasn’t been a scientifically documented cause for a migraine attack, researchers say that there may be various factors for a probable cause, including genetics, diet and lifestyle, weather, sleep cycle, anxiety and stress, among others. “The pain associated with migraine attacks is often invisible and difficult to describe to someone who has never experienced a migraine, making it challenging to pinpoint the exact triggers,” says Dr. Jennifer McVige, neurologist at Dent Neurologic Institute in Buffalo, NY. “Because the cause and symptoms differ from person to person, it’s important to speak to a healthcare professional for a personalized analysis and a proper diagnosis of the disease.”Healthcare professionals recommend keeping a diary to take note of potential triggers. Keeping track of what is going on before a headache or migraine comes on can be critical to recognize triggers or patterns, helping to avoid them as much as possible.What treatment options are available for Chronic Migraine?People with migraine may self-manage symptoms and wait on average four years before speaking with a healthcare professional. Once a healthcare professional provides an accurate diagnosis for Chronic Migraine, preventive treatments should be discussed as part of the treatment plan, as they can help prevent headaches and migraines before they start.BOTOX^® (onabotulinumtoxinA) is an effective, preventive treatment for Chronic Migraine. Since its FDA approval in 2010, BOTOX^® has been the #1 prescribed branded Chronic Migraine treatment, preventing on average 8-9 headache days and migraine/probable migraine days a month (vs 6 to 7 for placebo). BOTOX^® for Chronic Migraine is approximately a 15-minute treatment that is administered every 12 weeks by a headache specialist or neurologist.BOTOX^® for Chronic Migraine must be prescribed by your doctor.BOTOX^® (onabotulinumtoxinA) Important Safety InformationIndicationBOTOX^® is a prescription medicine that is injected to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting 4 or more hours each day in people 18 years or older.It is not known whether BOTOX^® is safe or effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month (episodic migraine).IMPORTANT SAFETY INFORMATIONBOTOX^® may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX^®:

• Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months.
• Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing, trouble swallowing.

There has not been a confirmed serious case of spread of toxin effect away from the injection site when BOTOX^® has been used at the recommended dose to treat chronic migraine.BOTOX^® may cause loss of strength or general muscle weakness, vision problems, or dizziness within hours to weeks of taking BOTOX^®. If this happens, do not drive a car, operate machinery, or do other dangerous activities.Do not receive BOTOX^® if you: are allergic to any of its ingredients (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc^® (rimabotulinumtoxinB), Dysport^® (abobotulinumtoxinA), or Xeomin^® (incobotulinumtoxinA); have a skin infection at the planned injection site.The dose of BOTOX^® is not the same as, or comparable to, another botulinum toxin product.Serious and/or immediate allergic reactions have been reported, including itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Get medical help right away if you experience symptoms; further injection of BOTOX^® should be discontinued.Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig’s disease, myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of BOTOX^®.Tell your doctor about all your medical conditions, including if you: have or have had bleeding problems; have plans to have surgery; had surgery on your face; weakness of forehead muscles; trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX^® can harm your unborn baby); are breastfeeding or plan to (it is not known if BOTOX^® passes into breast milk).Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using BOTOX^® with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you received BOTOX^® in the past.Tell your doctor if you received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc^®, Dysport^®, or Xeomin^® in the past (tell your doctor exactly which product you received); have recently received an antibiotic injection; take muscle relaxants; take allergy or cold medicines; take sleep medicine; take aspirin-like products or blood thinners.Other side effects of BOTOX^® include: dry mouth, discomfort or pain at injection site, tiredness, headache, neck pain, eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of eyelids, dry eyes; and drooping eyebrows.For more information refer to the Medication Guide or talk with your doctor.You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.Please see BOTOX^® full Product Information including Boxed Warning and Medication Guide.You can also visit www.BotoxChronicMigraine.com for more information about Chronic Migraine and BOTOX^®, and to find a physician in your area.Are you living with frequent, severe headaches? You may have Chronic Migraine