Abstract
Neuropathic pain is a chronic syndrome that is difficult to treat and often affects patients with leprosy. Recommended treatment includes the the use of analgesic drugs, codeine, tricyclic antidepressants, neuroleptics, anticonvulsants and thalidomide, but without consensus on uniform dose and fully satisfactory results. To analyze botulinum toxin type A (BoNT-A) effectiveness in treatment of chronic neuropathic pain in refractory leprous patients, as well as evaluate and compare the quality of life of patients before and after using the medication. We used a specific protocol including clinical, demographic, DN4 protocol, analogue scale (VAS), sensory evaluation and evaluation of the WHOQOL-BREF. Therapeutic intervention was performed with BOTOX® BTX-A 100U administered subcutaneously. Fifteen patients were evaluated on days 0, 10 and 60. Patients on VAS showed pain between 5 and 10, in one case there was complete pain relief in 60 days, while others showed improvement in the first week with the return of symptoms with less intensity after this period. WHOQOL-BREF's domains Quality of Life and Physical to have a significant increase in QOL. BoNT-A proved to be a good therapeutic option in relieving pain with improved quality of life for these patients.
Highlights
RESUMO A dor neuropática é uma síndrome crônica que é difícil de tratar e freqüentemente afeta pacientes com hanseníase
Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, a bacterium with predilection for skin cells and peripheral nerve tissue
Patients invited to participate in the study were selected from the referral center for the care of leprosy in the city of Belém, Pará, Brazil, represented by outpatient clinics of the Tropical Medicine Center (TMC) and the Health Center School - Marco (CSEM)
Summary
RESUMO A dor neuropática é uma síndrome crônica que é difícil de tratar e freqüentemente afeta pacientes com hanseníase. Objetivo: Busca-se analisar a efetividade da toxina botulínica tipo A no tratamento da dor neuropática crônica hansênica refratária. Conclusão: O estudo sugere que a TxBA é uma boa opção para os casos de dor neuropática crônica hansênica, no entanto, novos estudos são necessários para confirmar estes resultados. Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, a bacterium with predilection for skin cells and peripheral nerve tissue. It causes skin and neurological manifestations as well as inflammatory reactions with consequent sensory and motor changes[1]. Microscopic lesions’ alterations include degeneration of Schwann cells, loss of myelin, axonal retraction, periaxonal fibrosis and a variable amount of immunopathological
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