Efficacy and Safety of Botulinum Toxin A and Pulsed Radiofrequency on Postherpetic Neuralgia: A Randomized Clinical Trial

Abstract

This study evaluated the effectiveness and safety of botulinum toxin type A (BoNT-A) and pulsed radiofrequency (RF) in the clinical treatment of postherpetic neuralgia (PHN). A total of 100 patients with PHN were randomly divided into two groups (n = 50 per group): RF group and BoNT-A group. Based on conventional drug treatment, patients were treated with either a single nerve root pulsed radiofrequency therapy or a single local subcutaneous injection of BoNT-A in the lesion area. All the patients were followed up for 24 weeks on pain scores, sleep quality, anxiety, and depression scores, etc. In the last follow-up at the end of 24 weeks postoperation, the pain scores of patients in both groups were significantly lower than those before the operation (P < 0.05), indicating that both treatments were effective against PHN; however, there was no significant difference between these two groups (P > 0.05). It is noteworthy that the subcutaneous injection of BoNT-A is relatively easy to administer and less expensive compared to RF. Therefore, we believe that the subcutaneous injection of BoNT-A is an effective and safe method for the treatment of PHN.

Figure 1

Study flow diagram.

Figure 2

NRS and SQS scores of patients in both groups at baseline and 1 week, 4 weeks, 12 weeks, and 24 weeks postoperation. ^∗=P < 0.05 vs. baseline.

Figure 3

The incidence of different pain characteristics pre- and postoperation in two groups. (a) Stabbing pain, (b) burning pain, (c) numbness, (d) electric shock pain, (e) allodynia, (d) spontaneous pain. ^∗=P < 0.05 vs. RF.