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Air Force doctor studies new medication for traumatic brain injury patients

by Senior Airman Amber Bressler
59th Medical Wing Public Affairs

9/18/2009 - LACKLAND AIR FORCE BASE, Texas (AFNS) -- A neurologist at the Wilford Hall Medical Center here is studying a medication that may significantly reduce chronic headaches and migraines without all the usual side effects from oral medications.

Maj. (Dr.) Maria Alvarez, a 59th Medical Operations Squadron staff neurologist with a special interest in pain management, is the principal investigator for a case study involving 125 traumatic brain injury patients receiving a series of botulinum toxin, commonly known as Botox, injections to control their pain.

Doctor Alvarez said patients will receive the botulinum toxin injections every 12 weeks, which would be a huge improvement compared to taking oral medications up to three times a day.

TBI is a brain injury caused by sudden trauma to the brain. It occurs when the head suddenly and violently hits an object. TBI can range from mild to moderate or severe, depending on the extent of damage done to the brain.

"Standard methods of treating TBI-related headaches are oral medications that usually have adverse side effects, such as sleepiness and poor concentration, making the symptoms they already have worse," Doctor Alvarez said. "The only side effect patients may get from the botulinum toxin injection is dryness of mouth."

Symptoms of mild TBI include, but are not limited to headache, confusion, fatigue, mood changes, and trouble with memory, concentration, attention or thinking. Some of the moderate symptoms can be a headache that gets worse or doesn't go away, vomiting, seizures, loss of coordination, increased confusion and agitation. The most prominent of these symptoms are chronic headaches and cognitive dysfunction, also described as "brain fog."

"TBI is an increasingly recognized disorder affecting Armed Forces members returning from deployments to recent conflicts in Iraq and Afghanistan," Doctor Alvarez said. "Sixty-six percent of individuals wounded sustained blast injuries and, of these individuals, more than 8,600 suffer from TBI."

Many patients say they are willing to do anything to feel normal again.

"Since my injury, I've had some memory loss, migraines every week and at least a headache every day," said retired Chief Warrant Officer Robert O'Reilly. "I am willing to try anything at this point for some relief."

"If the results of the study are positive, it will benefit TBI patients, civilian and military alike, who are affected with chronic headaches," Doctor Alvarez said.

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