الفهرس 
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Abstract
Introduction: Migraine headaches are prevalent and periodical neurological disorders, they can cause severe effect on socioeconomic functioning and quality of life of patients. Some patients progress from having episodic migraine to chronic migraine, the latter affecting 2%-3% of the population. The primary objective of migraine prophylaxis is to reduce the frequency, duration, and severity of migraine attacks. The most common types of treatment are beta-blockers, anticonvulsants, and tricyclic antidepressants.Beta-blockers such as propranolol are used in non cardiac diseases such as migraine. Sodium valproate is an anticonvulsant drug which has been used extensively in recent years in migraine prophylaxis. Topiramate is also an anticonvulsant drug that is used for migraine prophylaxis.Botulinum toxin A is used in treatment of a variety of neurological and non neurological disorders. It was approved by the US Food and Drug Administration (FDA) in 2010 for the prophylaxis of chronic migraine.Aim of Work: This study was conducted to compare the effectiveness of botulinum toxin type A injection versus three oral drugs (propranolol, sodium valproate, and topiramate) in chronic migraine prophylaxis.Study Design: This study included 80 patients with chronic migraine. They were divided into 4 groups. Each group was treated with one of the studied drugs, then the patients were followed up at the 1st month, 3rd month and 6th month.Results and Conclusion: Prophylactic treatment of chronic migraine with BoNT-A, propranolol, Na valproate and topiramate showed significant differences from the baseline. More than 50% of patients in all groups showed moderate to marked improvement in the follow up periods. Also, there were no significant differences between the studied groups as for the effectiveness and safety issues.