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It presents a considerable therapeutic challenge. Botulinum toxin (BoNT) has emerged as a promising treatment for CM, particularly in patients unresponsive to standard pharmacological therapy or experiencing adverse effects. Its therapeutic benefit is based on blocking the release of nociceptive neuropeptides modulating pain pathways. Clinical efficacy and safety of BoNT have been demonstrated in multiple randomized controlled CM trials showing a significant reduction of headache frequency. 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