Abstract

Botulinum toxin type A (BTX-A) can be used to treat migraine and occipital neuralgia. BTX-A can also be used on trigeminal neuralgia (TN) patients who are refractory to medical treatment. Patients suffering from drug-refractory TN have been treated. We inject 50 U reconstituted BTX-A solution at the trigger zones. Symptoms, including pain duration, provoking factors, affected nerve branch, frequency of TN attacks, and severity of pain just before injections are evaluated 1 week, 1 month, and 6 months after injection. The overall response to treatment compared with values at baseline show men and women aged 28-67 years (mean 48.9 y) suffering from TN from 6 months to 24 years improve regarding frequency and severity of pain attacks; in our patients, pain was completely eradicated and there was no need for further medication. In some patients treated, nonsteroidal antiinflammatory drugs are enough to alleviate pain attacks, and some patients again respond to anticonvulsive drugs after injection. All patients develop higher pain thresholds after injections. A significant difference in frequency of attacks before injection and at 1 week, 1 month, and 6 months after injection is seen. Significant improvement in all patients up to 6 months after injection can be anticipated. Complications include transient paresis of the buccal or mandibular branch of the facial nerve . BTX-A is a minimally invasive method that can play a role in treating TN before resorting to other more invasive therapies, i.e., radiofrequency and surgery. © 2012 by Nova Science Publishers, Inc. All rights reserved.