Sustained effect of repeated botulinum toxin type A injections in trigeminal neuralgia

• Published in: Neurology and clinical neuroscience 2019-11, Vol.7 (6), p.318-321
• Main Authors: Gorimanipalli, Bhavya, Elavarasi, Arunmozhimaran, Goyal, Vinay, Goyal, Chanchal, Shukla, Garima, Behari, Madhuri
• Format: Article
• Language: English
• Subjects: botulinum toxin; Botulinum toxin type A; carbamazepine equivalent dose; drug‐refractory trigeminal neuralgia; Injection; injections; Neuralgia; neuropathic pain; Pain; Patients; Quality of life; Surgery; Trigeminal nerve; trigeminal neuralgia
• ISSN: 2049-4173; 2049-4173
• DOI: 10.1111/ncn3.12309

Background Trigeminal neuralgia is a chronic severely disabling facial pain syndrome, which significantly affects the quality of life of patients. Drugs are effective in controlling pain, but surgery is offered in drug‐refractory cases, which may not be feasible due to lack of availability of neurosurgeons or due to unfavorable risk‐benefit ratio or patient preference. Botulinum neurotoxin is an effective alternative in patients who are drug refractory and not willing for surgery. Objectives To study the safety and efficacy of repeated injections of botulinum neurotoxin in the treatment of drug‐refractory trigeminal neuralgia. Methodology Retrospective review of all case files was done, and required data were retrieved for analysis. Results In 23 patients, 54 injections of botulinum neurotoxin were given. The pain on VAS decreased from 9.08 ± 1.41 to 1.03 ± 1.69 with P 50% relief in pain. The efficacy of injection was comparable in single injection as well as repeated injections group. Conclusions Repeated injection of botulinum neurotoxin is safe and effective method of treatment in patients who do not want or those who are not fit for surgery.