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This patient presented with intense headache, facial and ear pain. Dr. Eli instructed the patient in the use of Migracises a technique for relaxing the muscles of the face and mouth. The patient still experienced some symptoms on exercise and splint therapy alone. Dr. Eli suggested Botox by Allergan as a possible treatment to be used in addition to the Migracises. The patient experienced immediate relief and was able to maintain a treated condition for over 8 months. Dr. Bradley Eli: All right welcome back we have been seeing you for a little while why did we see you initially? Patient: Initially I was having some pretty severe pain in my jaw and my face and headaches and ringing in my ears even some problems with equilibrium. Dr. Bradley Eli: How many Drs. And Dentists have you seen before you came to see us? Patient: I saw 2 Drs. (physicians) I was also under care of an Orthodontist and had braces a splint. I had a little over 2 and a half years of orthodontic work to try and correct it. Dr. Bradley Eli: Did that help you or hurt you or make no difference? Patient: I did not see any difference. Dr. Bradley Eli: We evaluated you and we proposed a treatment. Do you remember what the treatment has been? Patient: We started by doing the exercises. From there we had the splint, a night guard. Also some medication for when I had tightening in my muscles and pain. Dr. Bradley Eli: What kind of response did you have from that approach? Patient: I started to notice a difference gradually. It wasn't overnight it was more gradual. The exercises were what I noticed were really key, making sure that everything stayed loose. The pain would kind of come and go then I would come in and them we decided to look into the possibility of doing Botox. Dr. Bradley Eli: Did we do Botox? Patient: Yeah, we did, I put it off . I don't like to get into the too invasive . I was a little apprehensive but I did decide to try it. I noticed a huge difference. Dr. Bradley Eli: What specific difference did you notice from the Botox that you didn't have prior to the Botox? Patient: I noticed that the muscles in my face were clenched tight, and I didn't realize that before. There was also an absence of pain. Dr. Bradley Eli: How soon after you got your Botox injection did you feel the improvement? Patient: It was the same day. Dr. Bradley Eli: How long has it been since we did that? I think we did it February. Patient: It has been 8 months. Dr. Bradley Eli: So during that 8 months did it last the 8 months or did you start to get a return of symptoms? Patient: I do feel it ...some of the tightening coming back. A few months after the Botox treatment. I also noticed that because it wasn't hurting as much I wasn't doing my exercises as much, when I started doing my exercises and doing my normal regimen that I was doing it prolonged it (Botox effectiveness) it helped it. It's been a good 7 months that it has been tolerable. Dr. Bradley Eli: so what we are going to be doing today is repeating your Botox injection is that correct? Patient: Yes Dr. Bradley Eli: Today you are looking forward to it rather than being apprehensive about it. Is that correct? Patient: Yes, I was in tears the first time trying to decide if I was going to do it or not but I called up to make the appointment so.... Dr. Bradley Eli: do you have anything that you would like to share with everybody? Patient: Just that they should try everything and see what works for you because treatments are individual to the person. Production by Randy Clare and Associates