NEW YORK (Reuters Health) Oct 24 - Injections of botulinum toxin A substantially reduce the pain associated with trigeminal neuralgia, physicians report in the October 25th issue of Neurology, with pain relief lasting at least 60 days.
Dr. Elcio J. Piovesan, from Hospital de Clinicas da Universidade Federal do Parana in Curitiba, Brazil, and colleagues administered subcutaneous injections to four men and nine women who had trigeminal neuralgia for an average of 10.25 years and 8.22 years, respectively. Depending on the nerve branch, patients were treated with 6.45 to 9.11 units of botulinum toxin A.
Patients assessed the pain in the three branches of the trigeminal nerve with a 10-point visual analog scale (VAS), which ranged from 9.82 to 10 points at baseline. At day 10, VAS scores averaged 3.78 to 5.83. Maximal pain relief was noted at day 20 (average VAS 0.00 to 0.82).
Pain had increased slightly by day 60 (average VAS 1.82 to 3.17).
Prior to botulinum treatment, patients had used carbamazepine, gabapentin, codeine, Lioresal, and oxacarbamazepine as prophylactic treatment. "Most of our patients reduced their preventive medication by more than 50%," Dr. Piovesan's group notes, while "others stopped them completely, and some taking multiple medications converted to monotherapy."
Neurology 2005;65:1306-1308.
