Therapeutic efficacy and safety of botulinum toxin type A in trigeminal neuralgia: a systematic review

Yong Hu, Xiaofei Guan, Lin Fan, Mu Li, Yiteng Liao, Zhiyu Nie, Lingjing Jin, Yong Hu, Xiaofei Guan, Lin Fan, Mu Li, Yiteng Liao, Zhiyu Nie, Lingjing Jin

Abstract

Trigeminal neuralgia is a common disorder caused mainly by compression of the trigeminal nerve root by an overlying blood vessel. Pharmacotherapy and surgery are ineffective or unsuitable in many patients. Therefore, other therapeutic modalities have been tried, including injection of botulinum toxin type A (BTX-A). This study aims to systematically review the therapeutic efficacy and safety of BTX-A in trigeminal neuralgia. PubMed, EMBASE, Cochrane Library Clinical Trials and Web of Science from January 1966 to March 2013 were searched with the terms of "botulinum toxin" AND "trigeminal neuralgia", and references of related articles were traced. Data on the efficacy and safety of BTX-A in this disorder were extracted and analyzed by at least 2 reviewers. Data for individual studies were reported, and pooled data were analyzed if appropriate. Five prospective studies and one double-blind, randomized, placebo-controlled study were identified. Response was achieved in approximately 70-100% of patients, and the mean pain intensity and frequency were reduced by approximately 60-100% at 4 weeks after treatment in most studies. Major adverse events were not reported. Available studies show BTX-A may be effective in treatment of trigeminal neuralgia. However, well-designed randomized, controlled, double-blinded trial is still lacking. Future BTX-A treatment studies on optimal dose, duration of the therapeutic efficacy, common AEs, and the time and indications for repeat injection would be promising.

Figures

Figure 1
Figure 1
Flow chart illustrating the literature search and evaluation.
Figure 2
Figure 2
Percent of patients responding to BTX-A treatment.

References

    1. Headache Classification Subcommittee of the International Headache S. The international classification of headache disorders: 2nd edition. Cephalalgia. 2004;14(Suppl 1):9–160.
    1. Katusic S, Beard CM, Bergstralh E. et al.Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol. 1990;14:89–95. doi: 10.1002/ana.410270114.
    1. Hall GC, Carroll D, Parry D. et al.Epidemiology and treatment of neuropathic pain: the UK primary care perspective. Pain. 2006;14:156–162. doi: 10.1016/j.pain.2006.01.030.
    1. Dieleman JP, Kerklaan J, Huygen FJ. et al.Incidence rates and treatment of neuropathic pain conditions in the general population. Pain. 2008;14:681–688. doi: 10.1016/j.pain.2008.03.002.
    1. Koopman JS, Dieleman JP, Huygen FJ. et al.Incidence of facial pain in the general population. Pain. 2009;14:122–127. doi: 10.1016/j.pain.2009.08.023.
    1. Zakrzewska JM. Medical management of trigeminal neuropathic pains. Expert Opin Pharmacother. 2010;14:1239–1254. doi: 10.1517/14656561003767449.
    1. Yoshimasu F, Kurland LT, Elveback LR. Tic douloureux in Rochester, Minnesota, 1945-1969. Neurology. 1972;14:952–956. doi: 10.1212/WNL.22.9.952.
    1. Devor M, Amir R, Rappaport ZH. Pathophysiology of trigeminal neuralgia: the ignition hypothesis. Clin J Pain. 2002;14:4–13. doi: 10.1097/00002508-200201000-00002.
    1. Cheshire WP. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother. 2007;14:1565–1579. doi: 10.1586/14737175.7.11.1565.
    1. Tomasello F, Alafaci C, Angileri FF. et al.Clinical presentation of trigeminal neuralgia and the rationale of microvascular decompression. Neurol Sci. 2008;14(Suppl 1):S191–S195.
    1. Gnanalingham K, Joshi SM, Lopez B. et al.Trigeminal neuralgia secondary to Chiari’s malformation–treatment with ventriculoperitoneal shunt. Surg Neurol. 2005;14:586–588. doi: 10.1016/j.surneu.2004.06.021. discussion 588-589.
    1. Jo KW, Kong DS, Hong KS. et al.Long-term prognostic factors for microvascular decompression for trigeminal neuralgia. J Clin Neurosci. 2013;14:440–445. doi: 10.1016/j.jocn.2012.03.037.
    1. De Santi L, Annunziata P. Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment. Clin Neurol Neurosurg. 2012;14:101–107. doi: 10.1016/j.clineuro.2011.10.044.
    1. Nurmikko TJ, Gupta S, Maclver K. Multiple sclerosis-related central pain disorders. Curr Pain Headache Rep. 2010;14:189–195. doi: 10.1007/s11916-010-0108-8.
    1. Benoliel R, Epstein J, Eliav E. et al.Orofacial pain in cancer: part I–mechanisms. J Dent Res. 2007;14:491–505. doi: 10.1177/154405910708600604.
    1. Viviano M, Donati D, Lorenzini G. Metastatic carcinoma presenting as neuralgia involving the trigeminal nerve. J Can Dent Assoc. 2012;14:c32.
    1. Shulev Y, Trashin A, Gordienko K. Secondary trigeminal neuralgia in cerebellopontine angle tumors. Skull Base. 2011;14:287–294. doi: 10.1055/s-0031-1284218.
    1. Bornemann A, Bohl J, Hey O. et al.Amyloidoma of the gasserian ganglion as a cause of symptomatic neuralgia of the trigeminal nerve: report of three cases. J Neurol. 1993;14:10–14. doi: 10.1007/BF00870665.
    1. Cheng TM, Cascino TL, Onofrio BM. Comprehensive study of diagnosis and treatment of trigeminal neuralgia secondary to tumors. Neurology. 1993;14:2298–2302. doi: 10.1212/WNL.43.11.2298.
    1. Singh D, Jagetia A, Sinha S. Brain stem infarction: a complication of microvascular decompression for trigeminal neuralgia. Neurol India. 2006;14:325–326. doi: 10.4103/0028-3886.27177.
    1. Deshmukh VR, Hott JS, Tabrizi P. et al.Cavernous malformation of the trigeminal nerve manifesting with trigeminal neuralgia: case report. Neurosurgery. 2005;14:E623. doi: 10.1227/01.NEU.0000154063.05728.7E. discussion E623.
    1. Nurmikko TJ, Eldridge PR. Trigeminal neuralgia–pathophysiology, diagnosis and current treatment. Br J Anaesth. 2001;14:117–132. doi: 10.1093/bja/87.1.117.
    1. Wiffen PJ, Derry S, Moore RA, Carbamazepine for acute and chronic pain in adults. Cochrane Database Syst Rev. 2011.
    1. Wang QP, Bai M. Topiramate versus carbamazepine for the treatment of classical trigeminal neuralgia: a meta-analysis. CNS Drugs. 2011;14:847–857. doi: 10.2165/11595590-000000000-00000.
    1. Nasreddine W, Beydoun A. Oxcarbazepine in neuropathic pain. Expert Opin Investig Drugs. 2007;14:1615–1625. doi: 10.1517/13543784.16.10.1615.
    1. Gomez-Arguelles JM, Dorado R, Sepulveda JM. et al.Oxcarbazepine monotherapy in carbamazepine-unresponsive trigeminal neuralgia. J Clin Neurosci. 2008;14:516–519. doi: 10.1016/j.jocn.2007.04.010.
    1. Tate R, Rubin LM, Krajewski KC. Treatment of refractory trigeminal neuralgia with intravenous phenytoin. Am J Health Syst Pharm. 2011;14:2059–2061. doi: 10.2146/ajhp100636.
    1. Lu DP, Lu WI, Lu GP. Phenytoin (Dilantin) and acupuncture therapy in the treatment of intractable oral and facial pain. Acupunct Electrother Res. 2011;14:65–84.
    1. Jorns TP, Zakrzewska JM. Evidence-based approach to the medical management of trigeminal neuralgia. Br J Neurosurg. 2007;14:253–261. doi: 10.1080/02688690701219175.
    1. Canavero S, Bonicalzi V. Drug therapy of trigeminal neuralgia. Expert Rev Neurother. 2006;14:429–440. doi: 10.1586/14737175.6.3.429.
    1. Yang M, Zhou M, He L, Non-antiepileptic drugs for trigeminal neuralgia. Cochrane Database Syst Rev. 2011.
    1. Lenchig S, Cohen J, Patin D. A minimally invasive surgical technique for the treatment of posttraumatic trigeminal neuropathic pain with peripheral nerve stimulation. Pain physician. 2012;14:E725–E732.
    1. Zakrzewska JM, Akram H. Neurosurgical interventions for the treatment of classical trigeminal neuralgia. Cochrane Database Syst Rev. 2011.
    1. Trindade De Almeida AR, Secco LC, Carruthers A. Handling botulinum toxins: an updated literature review. Dermatol Surg. 2011;14:1553–1565. doi: 10.1111/j.1524-4725.2011.02087.x.
    1. Humeau Y, Doussau F, Grant NJ. et al.How botulinum and tetanus neurotoxins block neurotransmitter release. Biochimie. 2000;14:427–446. doi: 10.1016/S0300-9084(00)00216-9.
    1. Pearce LB, First ER, MacCallum RD. et al.Pharmacologic characterization of botulinum toxin for basic science and medicine. Toxicon. 1997;14:1373–1412. doi: 10.1016/S0041-0101(96)00180-8.
    1. Frampton JE. OnabotulinumtoxinA (BOTOX(R)): a review of its use in the prophylaxis of headaches in adults with chronic migraine. Drugs. 2012;14:825–845. doi: 10.2165/11208880-000000000-00000.
    1. Schulte-Mattler WJ, Martinez-Castrillo JC. Botulinum toxin therapy of migraine and tension-type headache: comparing different botulinum toxin preparations. Eur J Neurol. 2006;14(Suppl 1):51–54.
    1. Casale R, Tugnoli V. Botulinum toxin for pain. Drugs R D. 2008;14:11–27.
    1. Porta M, Camerlingo M. Headache and botulinum toxin. J Headache Pain. 2005;14:325–327. doi: 10.1007/s10194-005-0222-x.
    1. McMahon HT, Foran P, Dolly JO. et al.Tetanus toxin and botulinum toxins type A and B inhibit glutamate, gamma-aminobutyric acid, aspartate, and met-enkephalin release from synaptosomes. Clues to the locus of action. J Biol Chem. 1992;14:21338–21343.
    1. Purkiss JR, Welch MJ, Doward S. et al.Capsaicin stimulates release of substance P from dorsal root ganglion neurons via two distinct mechanisms. Biochem Soc Trans. 1997;14:542S.
    1. Welch MJ, Purkiss JR, Foster KA. Sensitivity of embryonic rat dorsal root ganglia neurons to Clostridium botulinum neurotoxins. Toxicon. 2000;14:245–258. doi: 10.1016/S0041-0101(99)00153-1.
    1. Bach-Rojecky L, Lackovic Z. Antinociceptive effect of botulinum toxin type a in rat model of carrageenan and capsaicin induced pain. Croat Med J. 2005;14:201–208.
    1. Cui M, Khanijou S, Rubino J. et al.Subcutaneous administration of botulinum toxin A reduces formalin-induced pain. Pain. 2004;14:125–133. doi: 10.1016/j.pain.2003.10.008.
    1. Luvisetto S, Marinelli S, Cobianchi S. et al.Anti-allodynic efficacy of botulinum neurotoxin A in a model of neuropathic pain. Neurosci. 2007;14:1–4. doi: 10.1016/j.neuroscience.2006.12.004.
    1. Park HJ, Lee Y, Lee J. et al.The effects of botulinum toxin A on mechanical and cold allodynia in a rat model of neuropathic pain. Canadian journal of anaesthesia = J canadien d’anesthesie. 2006;14:470–477. doi: 10.1007/BF03022619.
    1. Micheli F, Scorticati MC, Raina G. Beneficial effects of botulinum toxin type a for patients with painful tic convulsif. Clin Neuropharmacol. 2002;14:260–262. doi: 10.1097/00002826-200209000-00006.
    1. 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;14:e47–e50.
    1. 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;14:182–184. doi: 10.1097/00002508-200503000-00010.
    1. Piovesan EJ, Teive HG, Kowacs PA. et open study of botulinum-A toxin treatment of trigeminal neuralgia. Neurology. 2005;14:1306–1308. doi: 10.1212/01.wnl.0000180940.98815.74.
    1. Karsenty G, Denys P, Amarenco G. et al.Botulinum toxin A (Botox) intradetrusor injections in adults with neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic literature review. Eur Urol. 2008;14:275–287. doi: 10.1016/j.eururo.2007.10.013.
    1. Singh JA, Fitzgerald PM. Botulinum toxin for shoulder pain: a cochrane systematic review. J Rheumatol. 2011;14:409–418. doi: 10.3899/jrheum.101081.
    1. Mangera A, Andersson KE, Apostolidis A. et al.Contemporary management of lower urinary tract disease with botulinum toxin A: a systematic review of botox (onabotulinumtoxinA) and dysport (abobotulinumtoxinA) Eur Urol. 2011;14:784–795. doi: 10.1016/j.eururo.2011.07.001.
    1. Hansen H, Manchikanti L, Simopoulos TT. et al.A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2012;14:E247–E278.
    1. 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;14:443–450. doi: 10.1177/0333102412441721.
    1. 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;14:47–50. doi: 10.1016/j.tripleo.2010.04.043.
    1. Zuniga C, Diaz S, Piedimonte F. et al.Beneficial effects of botulinum toxin type A in trigeminal neuralgia. Arq Neuropsiquiatr. 2008;14:500–503. doi: 10.1590/S0004-282X2008000400012.
    1. Turk U, Ilhan S, Alp R. et al.Botulinum toxin and intractable trigeminal neuralgia. Clin Neuropharmacol. 2005;14:161–162. doi: 10.1097/01.wnf.0000172497.24770.b0.
    1. Borodic GE, Acquadro MA. The use of botulinum toxin for the treatment of chronic facial pain. J Pain. 2002;14:21–27. doi: 10.1054/jpai.2002.27142.
    1. Gazerani P, Staahl C, Drewes AM. et al.The effects of Botulinum Toxin type A on capsaicin-evoked pain, flare, and secondary hyperalgesia in an experimental human model of trigeminal sensitization. Pain. 2006;14:315–325. doi: 10.1016/j.pain.2006.04.014.
    1. Gazerani P, Pedersen NS, Staahl C. et al.Subcutaneous Botulinum toxin type A reduces capsaicin-induced trigeminal pain and vasomotor reactions in human skin. Pain. 2009;14:60–69. doi: 10.1016/j.pain.2008.10.005.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi