Therapeutic effect of Botulinum toxin-A in 88 patients with trigeminal neuralgia with 14-month follow-up.

Shuang Li,Ya-Ke Zheng,Nan-Chang Xie,Cai-Hong He,Hai-Feng Zhang,Ya-Jun Lian,Yun-Qing Ma,Yi Zhang,Yuan Chen,Chuan-Jie Wu

doi:10.1186/1129-2377-15-43

Shuang Li, Ya-Ke Zheng + Show 8 more

Open Access

https://doi.org/10.1186/1129-2377-15-43

Copy DOI

Abstract

BackgroundWe investigated the long-term effects and safety of botulinum toxin-A (BTX-A) for treating trigeminal neuralgia (TN). We also studied long-term maintenance of this therapeutic effect.MethodsA visual analog scale (VAS) score, pain attack frequency per day, patient’s overall response to treatment and side effects during 14-month follow-up were evaluated in 88 patients with TN receiving BTX-A. The primary endpoints were pain severity (assessed by VAS) and pain attack frequency per day. The secondary endpoint was the patient’s overall response to treatment, assessed using the Patient Global Impression of Change. The influence of different doses (≤50, 50–100 and ≥100 U) on the therapeutic effect was evaluated.ResultsTreatment was deemed “effective” within 1 month in 81 patients and at 2 months in 88 patients (100%). The shortest period of effective treatment was 3 months, and complete control of pain was observed in a maximum of 46 patients. The therapeutic effect decreased gradually after 3 months, and the prevalence of effective treatment at 14 months was 38.6%, with complete control of pain seen in 22 patients (25%). There was no significant difference in the prevalence of effective treatment between different dose groups at identical time points (p > 0.05). Three patients showed swelling at injection sites and 10 patients showed facial asymmetry, both of which disappeared spontaneously without special treatment.ConclusionLocal subcutaneous injection of BTX-A for TN treatment has considerable therapeutic effects lasting several months and is safe for this indication. At least one-quarter of patients maintained complete analgesia. The maintenance period of the therapeutic effect may be related to the reduction in the VAS score after the first injection of BTX-A.

Highlights

We investigated the long-term effects and safety of botulinum toxin-A (BTX-A) for treating trigeminal neuralgia (TN)
Comparison of effective values and pain attack frequency at different doses There was no significant difference in the prevalence of effective treatment between different dose groups at identical time points between 1 month and 14 months (p > 0.05) (Table 3)
In 2012, we reported 1 case of TN without recurrence in 2 years [17], which is beyond the period of relaxation of muscle tension elicited by BTX-A

Summary

Introduction

We investigated the long-term effects and safety of botulinum toxin-A (BTX-A) for treating trigeminal neuralgia (TN). Trigeminal neuralgia (TN) is characterized by sudden (usually unilateral), severe, brief, stabbing, recurrent pain in the distribution of one or more branches of the trigeminal nerve. Botulinum toxin A (BTX-A) is a type of exotoxin produced by Clostridium botulinum. It relaxes muscles through the release of acetylcholine at nerve–muscle junctions. BTX-A can inhibit secretion from glands through inhibition of the release of acetylcholine from cholinergic nerve terminals [3]. It is used in the treatment of bromhidrosis, hyperhidrosis, hygrostomia, vasomotor rhinitis, and rhinorrhea

Methods

Results

Discussion

Conclusion