Botulinum toxin in the treatment of trigeminal neuralgia: 6-Month follow-up

Medicine (Baltimore). 2017 Sep;96(39):e8133. doi: 10.1097/MD.0000000000008133.

Abstract

Background: Botulinum toxin type-A (BTX-A) has been successfully utilized to treat trigeminal neuralgia. In this study, through the use of a new technique, the efficacy of the injection of BTX-A to the maxillary and mandibular nerves was evaluated.

Methods: A total of 27 patients were injected with 100 Units of BTX-A to the maxillary and mandibular nerves. Visual analogue scale score and pain frequency were assessed before treatment and at the first week, second month, and sixth month after treatment. Patients with ≥50% reduction in mean pain score at the second and sixth month were defined as responders.

Results: A total of 27 patients were included in the study. BTX-A significantly reduced pain intensity and pain attack frequency at the first week, second month, and sixth month after treatment. At the second month, 74.1% of patients, at the sixth month, 88.9% of patients responded to treatment. Forty-four percent of patients did not experience any pain at the sixth month. The mean recurrence period was 87.7 ± 20.4. BTX-A was well tolerated and showed few treatment-related adverse events.

Conclusion: Injection to the maxillary and mandibular roots seems to be a highly effective method. In the event of recurrence, after each injection, the pain severity and attack frequency decreased.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Botulinum Toxins, Type A / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Male
  • Mandibular Nerve
  • Maxillary Nerve
  • Middle Aged
  • Neuromuscular Agents / administration & dosage*
  • Pain Measurement
  • Recurrence
  • Treatment Outcome
  • Trigeminal Neuralgia / drug therapy*

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A