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Botox is remarkably safe, especially considering it's a powerful toxin. Occasionally, a mild headache that lasts a few hours may occur after an injection in muscles of the forehead. Very rarely, though, that headache may become excruciating and can last as long as a month.
For tension type headaches where persistently chronic muscle contraction contributes to the headache, a partial paralysis of the muscle in the region of the pain does much to alleviate the headache. Please note that botox is NOT effective for severe stabbing pain in the cheek region or next to the eye.