Botulinum Toxin A in Treatment of Trigeminal Neuralgia – Latest Advances
Introduction
Botulinum toxin is basically a neurontin protein produced by the bacterium clostridium botulinum and is one of the most poisonous naturally occurring substances in the world.
Used to treat painful muscle spasms and as a cosmetic treatment, it is generally sold under the brand names Botox and Dysport. The use of botulinum toxin in the treatment of neurological disorders has significantly increased in the recent years.
Meanwhile, Tic Douloureux or Trigeminal Neuralgia (TN) is a neuropathic disorder causing episodes of intense pain in the eyes, lips, nose, scalp, forehead and jaw. The condition of TN is typically characterized by sudden and brief attacks of intense and stabbing pain and is usually limited to one side of the face.
This disorder generally develops after the age of 40. Besides, the incidence of trigeminal neuralgia has been found to be quite higher in women as compared to men.
Botulinum Toxin A and Trigeminal Neuralgia
Botulinum toxin A (BoNT/A) is now a well-accepted therapy for facial treatments and cosmetic purposes. However, recent advancements have also made it a valuable alternative for treating migraines and eye spasms.
Experts indicate that the botulinum toxin A has an antinociceptive effect, with transitory action over the trigeminal territory. It inhibits the release of neurotransmitters and is also believed to reduce peripheral and central sensitization.
Patients with intractable trigeminal neuralgia can have analgesic effects from the (BoNT/A) as these patients have the said sensitization, along with persistent pain. It has also been widely observed that since the patients with neuralgia-related chronic severe pain respond to the botulinum toxin A injection quite well, this form of therapy has emerged as a significant alternative to surgical treatment of such disorders.
Research and Analysis
A recent research conducted by the Brazilian and American researchers studied the effects of the botulinum toxin type A in as many as 13 patients suffering from trigeminal neuralgia. It was found that the pain significantly decreased in all the patients within a period of 10 days, while in 20 days, the patients did not exhibit any obvious symptoms.
Another study published recently evaluated the impact of the botulinum toxin A on a 75-year old man suffering from trigeminal neuralgia. The patient, who had trigeminal neuralgia in the left hemifacial region had an excruciating pain, which did not respond favorably to carbamazepine and amitriptyline. While no side effects were observed with the use of botulinum toxin A, the researchers also concluded that there was a concomitant reduction of pain and even the medication could be withdrawn.
In a yet another study undertaken, the researchers attempted to conduct a randomized, open-ended study to investigate the efficacy of botulinum injections in case of refractory trigeminal neuralgia. For this purpose, eight patients with trigeminal neuralgia were administered 100 U botulinum toxin through an injection into the zygomatic arch.
As in a majority of other cases, the study concluded that botulinum toxin A was quite effective in treating trigeminal neuralgia, without the risk of excessive side effects.
