Botulinum Neurotoxin for the Treatment of Neuropathic Pain

Gabriella Egeo, Luisa Fofi, Piero Barbanti, Gabriella Egeo, Luisa Fofi, Piero Barbanti

Abstract

Botulinum neurotoxin is widely used for the treatment of central and peripherical neurological conditions. Initially used to treat strabismus, over the years its use has been expanded also to spasticity and other neurological disorders. This review summarizes the evidence from the published literature regarding its effect on neuropathic pain. Almost all investigations were performed using onabotulinum toxin type A (BoNT/A). Most studies provided positive results, even though toxin formulation, dose, dilution, injection techniques, and sites are heterogeneous across studies. Future larger, high-quality, specifically designed clinical trials are warranted to confirm botulinum neurotoxin efficacy in neuropathic pain.

Keywords: botulinum toxin; disability; neuropathic pain; pain treatments; visual analog scale.

Copyright © 2020 Egeo, Fofi and Barbanti.

Figures

Figure 1
Figure 1
Studies assessing the efficacy of botulinum toxin in different types of neuropathic pain. TN: trigeminal neuralgia; PHN: post-herpetic neuralgia; DN: diabetic neuropathy; PSP: post-stroke pain; CTS: carpal tunnel syndrome; PTPS: post-thoracotomy pain syndrome; CPSP: chronic post-surgical pain; CPRS: complex regional pain syndrome; PLP: phantom limb pain; SCI: spinal cord injury; NTOS: neurogenic thoracic outlet syndrome; CPPS: Chronic pelvic pain syndrome.
Figure 2
Figure 2
Studies assessing the efficacy of botulinum toxin in different types of neuropathic pain. TN: trigeminal neuralgia; PHN: post-herpetic neuralgia; DN: diabetic neuropathy; PSP: post-stroke pain; occipital neuralgia; CTS: carpal tunnel syndrome; PTPS: post-thoracotomy pain syndrome; post-surgical pain; CRPS: complex regional pain syndrome; PLP: phantom limb pain; SCI: spinal cord injury; NTOS: neurogenic thoracic outlet syndrome; CPPS: Chronic pelvic pain syndrome.

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Source: PubMed

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