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Botulinum Toxin as Monotherapy in Symptomatic Trigeminal Neuralgia
Author(s) -
Lunde Hanne Marie Bøe,
Torkildsen Øivind,
Bø Lars,
Bertelsen Anne Kjørsvik
Publication year - 2016
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12791
Subject(s) - medicine , trigeminal neuralgia , botulinum toxin , refractory (planetary science) , adverse effect , analgesic , anesthesia , surgery , trigeminal nerve , physics , astrobiology
Background Trigeminal neuralgia (TN) is one of the most agonizing facial pain disorders that humans endure. Studies on onabotulinum toxin A (BTX‐A) treatment for TN are limited, but promising with respect to TN of no identifiable cause. We aimed to investigate the efficiency and safety of BTX‐A treatment in a 60‐year‐old male with diabetes mellitus who in March 2013 presented with TN caused by an exostosis in Meckel's cave. Methods The patient was medically treatment refractory due to insufficient pain relief and adverse events of hyperglycemia, and surgery was declined due to complex anatomy. As a last resort, BTX‐A was injected into the pain trigger zones of the trigeminal nerve (V5). Results Complete analgesia was reported 2 weeks after BTX‐A injection. Pain medications were discontinued and laboratory values returned to acceptable levels. Regular BTX‐A treatment during the next 28 months showed sustained analgesic effect. Conclusions BTX‐A has an excellent safety profile and may be efficient for patients with symptomatic TN not suited for conventional therapies.