The Use of Botulinum Toxin in the Treatment  of Trigeminal Neuralgia (Fifth Cranial Nerve)

The Trigeminal Neuralgia (TN) is described as neuropathic pain at the orofacial level, characterized by unbearable pain that can last from a few seconds to several minutes. The different treatments used for these patients are to numb the nerve, surgical, pharmacological, and the administration at extra and intraoral level of botulinum toxin, which is a neurotoxin produced in cultures of the bacterium Clostridium botulinum in a natural way; in the sporulation process are 7 subtypes being the subtype A the most used in neurological problems. The botulinum toxin acts as a neuromuscular blocker, by inhibiting the release of acetylcholine at the synaptic space, which is an important neurotransmitter to produce local muscle relaxation, and the patients report reductions in the frequency and intensity of pain with minimal side effects. The injection of botulinum toxin produces an effective pain reduction of neuropathic origin in the hyperalgesic tissue and is used as adjuvant therapy when oral medications do not give adequate control of pain. Over time it is expected to reduce the drugs as the patient tells that the pain has decreased or is being controlled. Patients are indicated the variation of time in which they can obtain relief of their pain. In patients with uncontrolled pain of the trigeminal nerve, the toxin is placed extraoral in the orofacial region with high effectiveness, but there is a lack of studies on the administration in the intraoral submucosal.

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Therapeutic use of botulinum toxin in pain treatment

Neuronal Signaling ◽

10.1042/ns20180058 ◽

2018 ◽

Vol 2 (3) ◽

Cited By ~ 5

Author(s):

Raj Kumar

Keyword(s):

Chronic Pain ◽

Nervous System ◽

Botulinum Toxin ◽

Acetylcholine Release ◽

Pain Treatment ◽

Muscle Relaxation ◽

Cholinergic Synapse ◽

Systems Research ◽

Release Of Acetylcholine ◽

Myofascial Syndrome

Botulinum toxin is one of the most potent molecule known to mankind. A neurotoxin, with high affinity for cholinergic synapse, is effectively capable of inhibiting the release of acetylcholine. On the other hand, botulinum toxin is therapeutically used for several musculoskeletal disorders. Although most of the therapeutic effect of botulinum toxin is due to temporary skeletal muscle relaxation (mainly due to inhibition of the acetylcholine release), other effects on the nervous system are also investigated. One of the therapeutically investigated areas of the botulinum neurotoxin (BoNT) is the treatment of pain. At present, it is used for several chronic pain diseases, such as myofascial syndrome, headaches, arthritis, and neuropathic pain. Although the effect of botulinum toxin in pain is mainly due to its effect on cholinergic transmission in the somatic and autonomic nervous systems, research suggests that botulinum toxin can also provide benefits related to effects on cholinergic control of cholinergic nociceptive and antinociceptive systems. Furthermore, evidence suggests that botulinum toxin can also affect central nervous system (CNS). In summary, botulinum toxin holds great potential for pain treatments. It may be also useful for the pain treatments where other methods are ineffective with no side effect(s). Further studies will establish the exact analgesic mechanisms, efficacy, and complication of botulinum toxin in chronic pain disorders, and to some extent acute pain disorders.

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Effectiveness, safety and tolerability of botulinum toxin in focal hyperhidrosis and dynamic facial wrinkles

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20185139 ◽

2019 ◽

Vol 5 (1) ◽

pp. 52

Author(s):

K. Gopalakrishnan

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Muscle Relaxation ◽

Botulinum Toxin Type A ◽

Complete Response ◽

Botulinum Toxin Type ◽

Palmar Hyperhidrosis ◽

Palmar Surface ◽

Release Of Acetylcholine ◽

Focal Hyperhidrosis

Background: Botulinum toxin is a potent neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction thereby causing localized muscle relaxation which smoothen the overlying skin and reduces dynamic facial wrinkles. Also clinical studies suggest that intra dermal injections of botulinum toxin are effective in the treatment of palmar hyperhidrosis by blocking the excessive sympathetic cholinergic sudomotor nerve traffic to the palmar surface of the hands.Methods: We treated twenty patients with palmar hyperhidrosis and fifteen patients with dynamic facial wrinkles with intra dermal botulinum toxin type A.Results: Among patients treated, complete response was seen in 90% of patients with hyperhidrosis and 70% for patients with facial wrinkles. The relapse of symptoms was highly variable among patients and the average relapse was seen at 14 weeks for both the indications. No major side effects noted.Conclusions: Botox is an effective and highly tolerable treatment for both hyperhidrosis and facial wrinkles.

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Case of iatrogenic botulism after botulinotherapy in clinical practice

Terapevticheskii arkhiv ◽

10.26442/terarkh20189011102-104 ◽

2018 ◽

Vol 90 (11) ◽

pp. 102-104

Author(s):

R A Ibatullin ◽

R V Magjanov

Keyword(s):

Botulinum Toxin ◽

Muscle Relaxation ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

Respiratory Arrest ◽

Good Safety Profile ◽

Release Of Acetylcholine ◽

Swallowing Difficulty ◽

Motor Nerves

Injections of botulinum toxin are widely used in different medical fields, namely neurology, urology, stomatology, cosmetology, gastroenterology etc. Preparations of botulinum toxin type A (BTA) prevent the release of acetylcholine at the endings of motor nerves leading to the long-term muscle relaxation. It has been acknowledged that treatment with BTA has very good safety profile and tolerability. Extremely rare but severe complication of botulinotherapy (BT) is a condition, which is associated with generalized muscle Weakness, swallowing difficulty, respiratory arrest, and may lead to the lethal outcomes in the solitary cases. Such disorders, which present like botulism, are known as botulism-like syndrome and iatrogenic botulism. We report a clinical case of such complication in the paper. The probability of the development of such rare but severe complications necessitates certain awareness and vigilance among clinicians performing BT.

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