Botulinum Toxin Treatment of Pain Disorders

Very few pharmaceutical agents in medicine have shown efficacy for treatment of so many diverse categoriesof disorders as botulinum neurotoxins . Botulinum neurotoxins was initially used for therapeutic application instrabismus, blepharospasm and hemifacial spasm, focal dystonia and spasticity, followed by the treatment ofwrinkles, hyperhidrosis and a great number of ensuing indications. An analgesic effect was first noticed whentreating symptoms or disorders associated with pain. First of all, there are the various headache syndromes.Animal studies have provided clear evidence for the analgesic effect of botulinum toxin through a variety ofmechanisms, most notable among them being inhibition of pain mediator release and antiinflammatory effects; however, a conclusive evaluation is still lacking. It is beyond doubt that botulinum neurotoxins helps in certainpain syndromes. We have still got to find out which the major ones are, what would be the optimum dose ofneurotoxins, and where the preferred site of injection should be. On the one hand, we hope to relieve pain inpatients whose symptoms could not be treated adequately before, and on the other, we expect new impulsesas to the pathogenesis and therapy of pain disorders to enhance greater advances for the benefit of ourpatients. This section presents an overview on the current state of pain management with botulinumneurotoxins.