Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul 14;14(7):e26856.
doi: 10.7759/cureus.26856. eCollection 2022 Jul.

Therapeutic Efficacy of Botulinum Toxin in Trigeminal Neuralgia

Abdul Mueez Alam Kayani  1 , Minollie Suzanne Silva  2 , Maleesha Jayasinghe  3 , Malay Singhal  4 , Snigdha Karnakoti  5 , Samiksha Jain  6 , Rahul Jena  7
Affiliations
Review

Therapeutic Efficacy of Botulinum Toxin in Trigeminal Neuralgia

Abdul Mueez Alam Kayani et al. Cureus. .

Abstract

Trigeminal neuralgia (TN) is a unilateral, paroxysmal, sharp, shooting, or jabbing pain that occurs in the trigeminal nerve divisions, including the ophthalmic (V1), maxillary (V2), and mandibular (V3) nerves. Typically, an episode is triggered by anything touching the face or teeth. TN is a clinical diagnosis with no specific diagnostic test; it is determined by the patient's medical history and pain description. Imaging is necessary to exclude secondary causes. The precise reason for TN is uncertain, but it is commonly believed to result from vascular compression of the trigeminal nerve root, typically near its origin in the pons. There are numerous surgical and medical treatment options available. The most frequently applied medical treatment therapies are carbamazepine and oxcarbazepine. Surgical alternatives are reserved for patients who do not respond to medical treatment. Botulinum toxin A (BTX-A) has emerged as a novel and promising alternative to surgery for individuals whose pain is unresponsive to medication. Multiple studies have established the safety and usefulness of BTX-A in treating TN, with the most significant benefits occurring between six weeks and three months after the surgery. This article reviews various studies published in the last 10 years regarding the therapeutic use of BTX-A in TN. These studies include various observational, clinical, pilot, and animal studies.

Keywords: botulinum injection; botulinum toxin-a; secondary trigeminal neuralgia; therapeutic interventions; trigeminal nerve.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Surgical and medical therapy options for trigeminal neuralgia (TN)
Image credit: Dr. Abdul Mueez Alam Kayani.
Figure 2
Figure 2. Mechanism of action of botulinum toxin (BTX-A)
Image credit: Dr. Abdul Mueez Alam Kayani.
Figure 3
Figure 3. Visual analog scale (VAS) to determine the pain severity and intensity
Image credit: Dr. Abdul Mueez Alam Kayani.
See this image and copyright information in PMC

References

    1. Trigeminal neuralgia: basic and clinical aspects. Araya EI, Claudino RF, Piovesan EJ, Chichorro JG. Curr Neuropharmacol. 2020;18:109–119. - PMC - PubMed
    1. Update on neuropathic pain treatment for trigeminal neuralgia. The pharmacological and surgical options. Al-Quliti KW. Neurosciences (Riyadh) 2015;20:107–114. - PMC - PubMed
    1. Primary care incidence and treatment of four neuropathic pain conditions: a descriptive study, 2002-2005. Hall GC, Carroll D, McQuay HJ. BMC Fam Pract. 2008;9:26. - PMC - PubMed
    1. Trigeminal neuralgia: an overview from pathophysiology to pharmacological treatments. Gambeta E, Chichorro JG, Zamponi GW. Mol Pain. 2020;16:1744806920901890. - PMC - PubMed
    1. Trigeminal neuralgia and its management. Bennetto L, Patel NK, Fuller G. BMJ. 2007;334:201–205. - PMC - PubMed

LinkOut - more resources