An Open Study of Botulinum-A Toxin Treatment of Idiopathic Trigeminal Neuralgia

Introduction: Trigeminal Neuralgia (TN) is a unilateral, recurrent, sharp facial pain disorder that is limited to the distribution of divisions of the trigeminal nerve. The aim of this study was to evaluate the efficacy of Botulinum neurotoxin type A (BTX-A) for alleviating the frequency and severity of TN pain. Materials and Methods: This trial was performed as a before and after study. We treated 31 patients (15 male and 16 female) with mean age of 52 year old that their diagnosis was made at least 4.5 years before. We injected BTX-A in various parts of face and particularly in the origin of mandibular and maxillary branches of trigeminal nerve. Injection volume was determined by the necessity and pain intensity measured with visual analog scale up to 100U. Patients were evaluated before and after the injection and were followed after week, and each month, for a three months period. Other related variables were recorded such as: toxin complications, pain status variations by brushing, chewing, cold weather and patient’s satisfaction with their therapy. Results: showed that after injection, pain intensity and frequency decreased after tooth brushing, chewing and cold weather (P<0.0001). Median of pain intensity decreased from 10 to 2 in all cases. Only 6% of patients affected to transient asymmetry and other complications were not observed. After 3 months of injection 71% of patients were inclined to reinjection. Conclusion: BTX-A could be used as an effective and safe treatment method for drug resistant TN. Also it can be used in patients who are not satisfied with oral anticonvulsants.