Abstract
Intractable chronic occipital neuralgia (ON) is an uncommon type of headache often experienced by patients in outpatient neurological clinics. Among patients unresponsive to oral neuralgia medications, needling or injections with several drugs were suggested alternatives for treating chronic ON. This study aimed to determine the effectiveness and safety of botulinum toxin type-A (BTX-A) injection treatments, where eight patients with unilateral chronic ON received BTX-A injections at the pain sites. The pain relief effect was observed 2 weeks after receiving the injections, gradually showing improvements up to 12 weeks after injection. There were no adverse events or changes from baseline in serologic studies and vital signs in any of the participants. The treatment’s pain-relieving effects were confirmed through regular, 12-week follow-ups, confirming the safety and effectiveness of BTX-A on chronic ON and suggesting that this method is an effective, novel alternative option for chronic ON treatment.
Highlights
Accepted: 30 April 2021Chronic occipital neuralgia (ON) is a refractory headache characterized by sudden, sharp, and pounding pain in the branches of the occipital nerves
Toxins 2021, 13, 332 pre-clinical serologic findings did not show any notable findings in the study participants, and no differences in the serologic findings before and after injecting the botulinum toxin type-A (BTX-A)
The preclinical serologic findings did not show notable findings in the analog study participants, The primary efficacy variable was theany change in the pain visual scale (VAS),and no differences in the serologic findings before and after injecting the evaluated by the investigator before and thrice on the 2nd, 4th, and 12th week after adThe primary efficacy variable was the change in the pain visual analog scale (VAS), ministration
Summary
Chronic occipital neuralgia (ON) is a refractory headache characterized by sudden, sharp, and pounding pain in the branches of the occipital nerves. ON can be described as bilateral or unilateral, typically accompanied by paresthesia around the occipital nerve [1]. Mild stage, this headache is commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, or anticonvulsants [2,3]. If the patient’s condition does not improve after using those medications, trigger point injection, physical therapy, pulsed radiofrequency therapy, occipital nerve surgical decompression, and botulinum toxin type-A (BTX-A) injection on target sites could be considered [4,5,6,7]. There are no clear treatment guidelines for chronic ON patients who do not respond to medical treatment. This study aimed to determine the efficacy and safety of BTX-A injections for use in chronic ON therapy
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