scholarly journals Subcutaneous Botulinum Toxin Injections for the Treatment of Chronically Painful Post-Craniotomy Scars: A Case Report of Two Patients Treated Successfully for More Than Eight Years

2017 ◽  
pp. 39-42
Author(s):  
Dennis Dykstra
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Treatment Effectiveness ◽  
Trigger Point ◽  
Botulinum Toxin Type A ◽  
Tumor Resection ◽  
Botulinum Toxin Type ◽  
Pain Medications ◽  
Oral Pain ◽  
Pain Sensitization

Recently, the use of botulinum toxin type A (BoNT-A) has been reported to help with neuropathic pain reduction in numerous conditions, including painful chronic scar formation. The mechanism by which BoNT-A inhibits pain is unclear, but it appears to involve a reduction of peripheral pain sensitization, which indirectly reduces central pain sensitization. Two patients who underwent surgery for brain tumor resection developed chronic painful neuropathic postcraniotomy scars. Their scar pain was not relieved with oral pain medications or trigger point injections with steroids but was helped significantly with BoNT-A injections. In the first patient, over the past 8 years, we have gradually increased her scar BoNT-A dose to 150 units diluted 2:1 with normal saline (NS) and injected the dose at 20 sites around her scar. She now reports her scar pain is 80%-90% resolved with the effect lasting 10 to 11 weeks. She denies side effects at this dose. In the second patient, over 9 years, we gradually increased the BoNT-A dose to 175 units diluted 2:1 with NS at 30 sites around her scar and in the left occipital area. She now notes her scar pain is 70%-75% improved from baseline with the effect lasting 8 to 10 weeks followed by a gradual reduction in benefit. She reports no side effects with this dose. The results of this 2-patient case study suggests BoNT-A (specifically onabotulinumtoxinA) may be helpful for patients with chronic postcraniotomy scar pain. Further studies on the dose, injection sites and timing follow-up injections are needed to determine treatment effectiveness for this patient population. Key words: Scar pain, Botulinum toxin, chronic pain, subcutaneous, injections, post-craniotomy

Injection of Botulinum Toxin Type A (Botox®) for Severe Primary Axillary Hyperhidrosis : Treatment Effectiveness and Satisfaction

2014 ◽  
Vol 76 (3) ◽  
pp. 248-252
Author(s):  
Yuichiro OHSHIMA ◽  
Takeshi YANAGISHITA ◽  
Keiko ITO ◽  
Yasuhiko TAMADA ◽  
Daisuke WATANABE
Keyword(s):  
Botulinum Toxin ◽  
Treatment Effectiveness ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Axillary Hyperhidrosis

scholarly journals Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Stefano Scamoni ◽  
Luigi Valdatta ◽  
Claudia Frigo ◽  
Francesca Maggiulli ◽  
Mario Cherubino
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Subjective Rating ◽  
Axillary Hyperhidrosis ◽  
Compensatory Hyperhidrosis ◽  
Iodine Test ◽  
Local Injections

Background. Local injections of Botulinum toxin type A (BTX-A) are an effective and safe solution for primary bilateral axillary hyperhidrosis. Traditional treatments are often ineffective and difficult to tolerate. This study was performed to assess the efficacy and safety of Botulinum toxin type A in the treatment of these diseases and to evaluate the reliability of patient’s subjective rating in the timing of repeat injections. Methods. From 2007 to 2008, we included in the study and treated a total of 50 patients, and we used the Minor’s iodine test and the hyperhidrosis diseases severity scale as initial inclusion criteria and also for evaluating the followup, comparing to patient’s subjective rating. We used also a specific questionnaire to evaluate the level of pain, the onset of the effect, any eventual adverse effect of the treatment, the onset of compensatory hyperhidrosis, and the global grade of satisfaction. The data were analyzed using standard statistical methods. Results. 88% of patients were totally satisfied and all patients repeated the treatment during all the study. The symptom-free interval was in median 6 months with an average improving of HDSS of 1.5 points. In 86%, there was a complete accordance between the subjective patient’s demand of the repetition of the treatment and the positivity to Minor test and HDSS. No major side effects happened. Conclusion. Local injections of Botulinum toxin type A (BTX-A) result in an effective and safe solution for bilateral axillary primary hyperhidrosis for the absence of significant morbidity, side effects, and lack of efficacy or duration. The only defects are the need of repetition of the treatment and relative costs.

scholarly journals Patient-Reported Side Effects of Intradetrusor Botulinum Toxin Type A for Idiopathic Overactive Bladder Syndrome

2011 ◽  
Vol 86 (1) ◽  
pp. 68-72 ◽  
Author(s):  
Ricarda M. Bauer ◽  
Christian Gratzke ◽  
Alexander Roosen ◽  
Yasmin Hocaoglu ◽  
Margit E. Mayer ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Overactive Bladder ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Overactive Bladder Syndrome ◽  
Patient Reported

scholarly journals Treatment of hemifacial spasm with botulinum toxin type a: effective, long lasting and well tolerated

2017 ◽  
Vol 75 (2) ◽  
pp. 87-91 ◽  
Author(s):  
Jean Pierre Mette Batisti ◽  
Alais Daiane Fadini Kleinfelder ◽  
Natália Bassalobre Galli ◽  
Adriana Moro ◽  
Renato Puppi Munhoz ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Hemifacial Spasm ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Term Effect ◽  
Long Term Effect

ABSTRACT Hemifacial spasm (HFS) is a common movement disorder characterized by involuntary tonic or clonic contractions of the muscles innervated by the facial nerve. Objective To evaluate the long-term effect of botulinum toxin type A (BTX-A) in the treatment of HFS. Methods A retrospective analysis of patients treated at the Movement Disorders Outpatient Clinic in the Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, from 2009 to 2013 was carried out. A total of 550 BTX-A injections were administered to 100 HFS patients. Results Mean duration of improvement following each injection session was 3.1 months, mean latency to detection of improvement was 7.1 days and mean success rate was 94.7%. Patients were evaluated at an interval of 5.8 months after each application. Adverse effects, which were mostly minor, were observed in 37% of the patients at least once during follow-up. The most frequent was ptosis (35.1%). Conclusion Treatment of HFS with BTX-A was effective, sustainable and safe and had minimal, well-tolerated side effects.

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> We treated twenty patients with palmar hyperhidrosis and fifteen patients with dynamic facial wrinkles with intra dermal botulinum toxin type A.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> Botox is an effective and highly tolerable treatment for both hyperhidrosis and facial wrinkles.</p>

Current and Emerging Treatments for Cervical Dystonia

CNS Spectrums ◽  
2000 ◽  
Vol 5 (S5) ◽  
pp. s1-s8 ◽  
Author(s):  
Stewart A. Factor ◽  
Mark F. Lew ◽  
Richard M. Trosch
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Cervical Dystonia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Limited Range ◽  
Spasmodic Torticollis ◽  
Double Blind ◽  
Limited Range Of Motion

ABSTRACTCervical dystonia (CD), also known as spasmodic torticollis, is the most common of the focal dystonias. Muscle hypertrophy is present in nearly all patients, and neck pain is associated with CD in about 80% of patients. Remissions can occur in about 20% of patients, though most last under a year.Medical therapies have not generally worked well for patients with CD, and are typically associated with many side effects. Botulinum toxin (BT), which causes fewer side effects, has been considered the treatment of choice. Beyond medical therapy, various surgeries for CD have been performed for many decades. Of surgical treatments now in use, selective peripheral denervation is the most common.In CD, botulinum toxin type A (BT-A) targets pain, dystonic posturing, limited range of motion, and tremor. BT type B (BT-B) is a serotype of BT that is ontogenetically distinct from the type A toxin. There have been three randomized, multicenter, double-blind, placebo-controlled trials of BT-B. It appears that BT-B is a safe and effective treatment for patients with CD who are responsive or resistant to BT-A.

scholarly journals Efficacy of Botulinum Toxin Type A in Trigeminal Neuralgia in a South Asian Cohort

2018 ◽  
Vol 09 (01) ◽  
pp. 100-105 ◽  
Author(s):  
Manjula Chandragomi Caldera ◽  
Sameera Jayan Senanayake ◽  
Sujith Priyankara Perera ◽  
Nadeeke Nidhan Perera ◽  
Ranjanie Gamage ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Trigger Point ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Antinociceptive Effect ◽  
Botulinum Toxin Type ◽  
Pain Scores ◽  
Significant Difference ◽  
Asian Cohort

ABSTRACT Introduction: The antinociceptive effect of botulinum toxin-A (BTX-A) in trigeminal neuralgia (TN) has been described. We evaluated effects of BTX-A in relieving pain in patients with refractory TN at National Hospital of Sri Lanka. Materials and Methods: Pain in patients with TN was assessed using a visual analog from 0 to 10. Three months after commencement of drug therapy with ≥2 drugs including one first-line drug (carbamazepine/oxcarbazepine), pain scores were re-assessed. Twenty-two patients who did not report improvement of ≥50% at 90 days’ posttreatment were recruited. They were given adjunct BTX-A directly to the trigger point (if identified) or intradermal. Pain scores were assessed at 10, 20, 30, 60, and 90 days’ posttreatment. Results: There was a statistically significant improvement in mean pain scores at 10, 20, 30, 60, and 90 days’ posttreatment (5.59 [standard deviation (SD) = 2.7], 5.68 [SD = 2.6], 5.27 [SD = 3.2], 4.77 [SD = 3.7], and 5.32 [SD = 4.0]) compared to pre-BTX-A treatment (7.14, SD = 2.2). Percentage reduction in mean pain score ranged from 20.4% to 33.1%. Maximum response was at day 60 post-BTX-A (50% had ≥50% reduction in pain). No significant difference was found in response with higher doses and injection strategy. Conclusion: Consistent statistically significant reductions in pain scores at the aforesaid intervals compared to pretreatment means that there is a place for BTX in refractory TN.

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