Children’s National study finds Botox cuts pediatric chronic migraine headaches
Findings address an evidence gap for children and adolescents with limited treatment options
WASHINGTON (August 1, 2026) – A prospective study led by researchers at Children’s National found that onabotulinumtoxinA (ONA), commonly known as Botox, reduced headache frequency and headache-related disability in children and young adults with chronic migraine, adding important evidence to support its use in a pediatric population where treatment options remain limited.
The study, published in Pediatric Neurology , followed 45 patients ages 12 to 22 with chronic migraine who received ONA injections using the Phase II Research Evaluating Migraine Prophylaxis Therapy (PREEMPT-2) protocol at the Children’s National Headache Clinic.
While ONA is FDA-approved as a preventive treatment for adults with chronic migraine, it has not been approved for pediatric migraine because of limited and inconsistent data in children and adolescents. That lack of evidence has also created challenges for insurance coverage, limiting access for many families.
“Our study helps address an important evidence gap,” said Jeffrey Strelzik, MD , director of the Headache Injection Program at Children’s National and co-senior author of the study. “By demonstrating reductions in both headache frequency and disability, these findings contribute to the growing body of research supporting the use of onabotulinumtoxinA in appropriately selected pediatric patients.”
Key findings:
In addition to reducing headache frequency, ONA significantly lowered headache-related disability, as measured by the Headache Impact Test (HIT-6), suggesting meaningful improvements in patients’ daily functioning and quality of life.
“Chronic migraine can have a profound impact on a child’s education, social development and overall well-being,” said Dr. Strelzik. “Our findings suggest that onabotulinumtoxinA may be an effective treatment option for pediatric patients with chronic migraine, including some who experience headaches every day.”
Children’s National is among the few centers in the region with a dedicated Headache Injection Program for children and adolescents with chronic migraine. As part of the Headache Program , it offers a multifaceted approach that combines lifestyle changes, behavioral strategies, devices and procedures such as Botox injections to improve headache-related quality of life. The program performs more than 200 ONA procedures each year, offers peripheral nerve blocks and gives patients access to emerging migraine therapies through clinical trials, including studies of cGRP-targeted treatments.
The researchers say additional studies are needed to further define which patients are most likely to benefit from treatment and to continue building the evidence needed to improve access for children with chronic migraine.
Media contact: Beth Riggs | media@childrensnational.org | (202) 476-4500
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About Children’s National
For 155 years, Children’s National in Washington, D.C., has delivered expert pediatric care at every milestone. As the region’s only standalone children’s hospital, kids have been the center of its mission since 1870. Today, it is one of the top 10 children’s hospitals in the nation and ranked in all specialties evaluated by U.S. News & World Report. Children’s National is transforming pediatric medicine for all children.
The Children’s National Research & Innovation Campus opened in 2021, a first-of-its-kind pediatric hub dedicated to developing new and better ways to care for kids. Children’s National has been designated four times in a row as a Magnet ® hospital, demonstrating the highest standards of nursing and patient care delivery. This pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty care locations in the D.C. metropolitan area, including Maryland and Virginia. Children’s National is home to the Children’s National Research Institute and Sheikh Zayed Institute for Pediatric Surgical Innovation . It is recognized for its expertise and innovation in pediatric care and as a strong voice for children through advocacy at the local, regional and national levels.
In 1987, Children’s National founded Safe Kids Worldwide , a non-profit dedicated to reducing unintentional injuries among children through comprehensive national and global education, research and advocacy. As a non-profit, Children's National relies on generous donors to help ensure that every child receives the care they need.
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Pediatric Neurology
1-Aug-2026