Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Neurologia i Neurochirurgia Polska
MENU
Shortcuts Submit an article Guide for Authors Special collections Ahead Of Print Reviewers 2023

open access

Vol 53, No 5 (2019)
Review Article
Submitted: 2019-04-04
Accepted: 2019-05-22
Published online: 2019-08-09
View PDF Download PDF file
Get Citation

Botulinum toxin type A as an alternative way to treat trigeminal neuralgia: a systematic review

Hubert Ostrowski1, Justyna Roszak1, Oskar Komisarek2
DOI: 10.5603/PJNNS.a2019.0030
·
Pubmed: 31397877
·
Neurol Neurochir Pol 2019;53(5):327-334.
Affiliations
  1. Studenckie Koło Naukowe Chirurgii Szczękowo-Twarzowej oraz Ortognatycznej Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu
  2. Katedra i Klinika Ortopedii Szczękowej i Ortodoncji Uniwersytetu Medycznego w Poznaniu

open access

Vol 53, No 5 (2019)
Review articles
Submitted: 2019-04-04
Accepted: 2019-05-22
Published online: 2019-08-09

Abstract

Introduction. Trigeminal neuralgia (TN) is one of the most common neurological diseases involving the orofacial region. It affects mainly the older population, usually after the age of 60, and more commonlywomen. It involves the fifth cranial nerve and manifests as paroxysmal, unilateral, severe, shock-like or knife-like pain of from a second to two minutes’ duration. Usually pain attacks arise spontaneously, but they can also be precipitated by triggers such as cold weather, brushing teeth or shaving. The ICHD-3 classification divides TN into classical, secondary and idiopathic. Current treatment includes pharmacological and surgical methods. Anticonvulsants, such as carbamazepine and oxcarbazepine, are the first line therapy. Microvascular decompression is the most common and most effective way to treat TN surgically.
However, none of these methods is free from complications. Moreover, 25–50% of patients became refractory to drug therapy. Some studies have shown that a new therapy that uses a Botulinum toxin type A can be a safe and effective way to treat trigeminal neuralgia.

Methods. Literature from the PubMed base and the Main Medical Library from the last 18 years was analysed. Forty-three items were obtained; after verification, seven articles were included.

Aim of the study. To look at current guidelines about treating trigeminal neuralgia with Botulinum Toxin type A in patients who are refractory to drug therapy or who do not want to undergo surgical treatment.

Conclusion. BoNT-A therapy is a safe and effective method of treating trigeminal neuralgia.

Abstract

Introduction. Trigeminal neuralgia (TN) is one of the most common neurological diseases involving the orofacial region. It affects mainly the older population, usually after the age of 60, and more commonlywomen. It involves the fifth cranial nerve and manifests as paroxysmal, unilateral, severe, shock-like or knife-like pain of from a second to two minutes’ duration. Usually pain attacks arise spontaneously, but they can also be precipitated by triggers such as cold weather, brushing teeth or shaving. The ICHD-3 classification divides TN into classical, secondary and idiopathic. Current treatment includes pharmacological and surgical methods. Anticonvulsants, such as carbamazepine and oxcarbazepine, are the first line therapy. Microvascular decompression is the most common and most effective way to treat TN surgically.
However, none of these methods is free from complications. Moreover, 25–50% of patients became refractory to drug therapy. Some studies have shown that a new therapy that uses a Botulinum toxin type A can be a safe and effective way to treat trigeminal neuralgia.

Methods. Literature from the PubMed base and the Main Medical Library from the last 18 years was analysed. Forty-three items were obtained; after verification, seven articles were included.

Aim of the study. To look at current guidelines about treating trigeminal neuralgia with Botulinum Toxin type A in patients who are refractory to drug therapy or who do not want to undergo surgical treatment.

Conclusion. BoNT-A therapy is a safe and effective method of treating trigeminal neuralgia.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

trigeminal neuralgia, neuropathic pain, trigeminal nerve, botulinum toxin

About this article
Title

Botulinum toxin type A as an alternative way to treat trigeminal neuralgia: a systematic review

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 5 (2019)

Article type

Review Article

Pages

327-334

Published online

2019-08-09

Page views

3510

Article views/downloads

928

DOI

10.5603/PJNNS.a2019.0030

Pubmed

31397877

Bibliographic record

Neurol Neurochir Pol 2019;53(5):327-334.

Keywords

trigeminal neuralgia
neuropathic pain
trigeminal nerve
botulinum toxin

Authors

Hubert Ostrowski
Justyna Roszak
Oskar Komisarek

References (41)
  1. Dieleman JP, Kerklaan J, Huygen FJ, et al. Incidence rates and treatment of neuropathic pain conditions in the general population. Pain. 2008; 137(3): 681–688.
    CrossRefPubMed
  2. Koopman JS, Dieleman JP, Huygen FJ, et al. Incidence of facial pain in the general population. Pain. 2009; 147(1-3): 122–127.
    CrossRefPubMed
  3. Nurmikko TJ, Jensen TS. Trigeminal neuralgia and other facial neuralgias. In: Olesen J, Goadsby PJ, Ramadan NM, Tfelt-Hansen P, Welch KMA, eds. The Headaches. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006; p. 1053-62; [chapter. ; 38.
  4. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33(9): 629–808.
    CrossRefPubMed
  5. Wu M, Fu X, Ji Y, et al. Microvascular Decompression for Classical Trigeminal Neuralgia Caused by Venous Compression: Novel Anatomic Classifications and Surgical Strategy. World Neurosurg. 2018; 113: e707–e713.
    CrossRefPubMed
  6. Di Stefano G, Truini A, Cruccu G. Current and Innovative Pharmacological Options to Treat Typical and Atypical Trigeminal Neuralgia. Drugs. 2018; 78(14): 1433–1442.
    CrossRefPubMed
  7. Obermann M. Treatment options in trigeminal neuralgia. Therapeutic Advances in Neurological Disorders. 2010; 3(2): 107–115.
    CrossRef
  8. Piovesan EJ, Teive HG, Kowacs PA, et al. An open study of botulinum-A toxin treatment of trigeminal neuralgia. Neurology. 2005; 65(8): 1306–1308.
    CrossRefPubMed
  9. Allam N, Brasil-Neto JP, Brown G, et al. Injections of botulinum toxin type a produce pain alleviation in intractable trigeminal neuralgia. Clin J Pain. 2005; 21(2): 182–184.
    PubMed
  10. Guo BL, Zheng CX, Sui BD, et al. A closer look to botulinum neurotoxin type A-induced analgesia. Toxicon. 2013; 71: 134–139.
    CrossRefPubMed
  11. Safarpour Y, Jabbari B. Botulinum toxin treatment of pain syndromes –an evidence based review. Toxicon. 2018; 147: 120–128.
    CrossRef
  12. Bendtsen L, Sacco S, Ashina M, et al. Guideline on the use of onabotulinumtoxinA in chronic migraine: a consensus statement from the European Headache Federation. J Headache Pain. 2018; 19(1): 91.
    CrossRefPubMed
  13. Aschehoug I, Bratbak DF, Tronvik EA. Long-Term Outcome of Patients With Intractable Chronic Cluster Headache Treated With Injection of Onabotulinum Toxin A Toward the Sphenopalatine Ganglion - An Observational Study. Headache. 2018; 58(10): 1519–1529.
    CrossRefPubMed
  14. Rosales RL, Efendy F, Teleg ESa, et al. Botulinum toxin as early intervention for spasticity after stroke or non-progressive brain lesion: A meta-analysis. J Neurol Sci. 2016; 371: 6–14.
    CrossRefPubMed
  15. Santamato A, Cinone N, Panza F, et al. Botulinum Toxin Type A for the Treatment of Lower Limb Spasticity after Stroke. Drugs. 2019; 79(2): 143–160.
    CrossRefPubMed
  16. Wu CJ, Lian YJ, Zheng YK, et al. Botulinum toxin type A for the treatment of trigeminal neuralgia: results from a randomized, double-blind, placebo-controlled trial. Cephalalgia. 2012; 32(6): 443–450.
    CrossRefPubMed
  17. Zúñiga C, Piedimonte F, Díaz S, et al. Acute treatment of trigeminal neuralgia with onabotulinum toxin A. Clin Neuropharmacol. 2013; 36(5): 146–150.
    CrossRefPubMed
  18. Shehata HS, El-Tamawy MS, Shalaby NM, et al. Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia? J Headache Pain. 2013; 14: 92.
    CrossRefPubMed
  19. Li S, Lian YJ, Chen Y, et al. Therapeutic effect of Botulinum toxin-A in 88 patients with trigeminal neuralgia with 14-month follow-up. J Headache Pain. 2014; 15: 43.
    CrossRefPubMed
  20. Zhang H, Lian Y, Ma Y, et al. Two doses of botulinum toxin type A for the treatment of trigeminal neuralgia: observation of therapeutic effect from a randomized, double-blind, placebo-controlled trial. J Headache Pain. 2014; 15: 65.
    CrossRefPubMed
  21. Zhang H, Lian Y, Xie N, et al. Single-dose botulinum toxin type a compared with repeated-dose for treatment of trigeminal neuralgia: a pilot study. J Headache Pain. 2017; 18(1): 81.
    CrossRefPubMed
  22. Liu J, Xu YY, Zhang QL, et al. Efficacy and Safety of Botulinum Toxin Type A in Treating Patients of Advanced Age with Idiopathic Trigeminal Neuralgia. Pain Res Manag. 2018; 2018: 7365148.
    CrossRefPubMed
  23. Yadav YR, Nishtha Y, Sonjjay P, et al. Trigeminal Neuralgia. Asian J Neurosurg. 2017; 12(4): 585–597.
    CrossRefPubMed
  24. Gronseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008; 71(15): 1183–1190.
    CrossRefPubMed
  25. Keränen T, Sivenius J. Side effects of carbamazepine, valproate and clonazepam during long-term treatment of epilepsy. Acta Neurol Scand Suppl. 1983; 97: 69–80.
    PubMed
  26. Fang S, Gong ZC. [Adverse effects of oxcarbazepine]. Zhongguo Dang Dai Er Ke Za Zhi. 2015; 17(4): 414–419.
    PubMed
  27. Bick SKB, Eskandar EN. Surgical Treatment of Trigeminal Neuralgia. Neurosurg Clin N Am. 2017; 28(3): 429–438.
    CrossRefPubMed
  28. Micheli F, Scorticati MC, Raina G. Beneficial effects of botulinum toxin type a for patients with painful tic convulsif. Clin Neuropharmacol. 2002; 25(5): 260–262.
    PubMed
  29. Aoki KR. Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache. 2003; 43 Suppl 1: S9–15.
    PubMed
  30. Wu C, Xie N, Lian Y, et al. Central antinociceptive activity of peripherally applied botulinum toxin type A in lab rat model of trigeminal neuralgia. Springerplus. 2016; 5: 431.
    CrossRefPubMed
  31. Yang KY, Kim MJ, Ju JS, et al. Antinociceptive Effects of Botulinum Toxin Type A on Trigeminal Neuropathic Pain. J Dent Res. 2016; 95(10): 1183–1190.
    CrossRefPubMed
  32. Lunde HM, Torkildsen Ø, Bø L, et al. Botulinum Toxin as Monotherapy in Symptomatic Trigeminal Neuralgia. Headache. 2016; 56(6): 1035–1039.
    CrossRefPubMed
  33. Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002; 3(1): 21–27.
    PubMed
  34. Herrero Babiloni A, Kapos FP, Nixdorf DR. Intraoral administration of botulinum toxin for trigeminal neuropathic pain. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 121(6): e148–e153.
    CrossRefPubMed
  35. Burmeister J, Holle D, Bock E, et al. Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial. Trials. 2015; 16: 550.
    CrossRefPubMed
  36. Bohluli B, Motamedi MH, Bagheri SC, et al. Use of botulinum toxin A for drug-refractory trigeminal neuralgia: preliminary report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111(1): 47–50.
    CrossRefPubMed
  37. Ngeow WC, Nair R. Injection of botulinum toxin type A (BOTOX) into trigger zone of trigeminal neuralgia as a means to control pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(3): e47–e50.
    CrossRefPubMed
  38. Wu C, Xie N, Liu H, et al. A new target for the treatment of trigeminal neuralgia with botulinum toxin type A. Neurol Sci. 2018; 39(3): 599–602.
    CrossRefPubMed
  39. Türk Börü Ü, Duman A, Bölük C, et al. Botulinum toxin in the treatment of trigeminal neuralgia: 6-Month follow-up. Medicine (Baltimore). 2017; 96(39): e8133.
    CrossRefPubMed
  40. Volcy M, Tepper SJ, Rapoport AM, et al. Botulinum toxin A for the treatment of greater occipital neuralgia and trigeminal neuralgia: a case report with pathophysiological considerations. Cephalalgia. 2006; 26(3): 336–340.
    CrossRefPubMed
  41. Zakrzewska JM. Botulinum toxin for trigeminal neuralgia--do we have the evidence? Cephalalgia. 2012; 32(15): 1154–5; author reply 1156.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl