Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

Sycha, Thomas; Kranz, Georg S.; Auff, Eduard; Schnider, Peter

doi:10.1007/s00415-004-1106-8

Cited by 38 publications

(37 citation statements)

References 41 publications

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“…This was highlighted by Zakrzewska et al 15 and discussed by Sycha et al 31 , who claimed that the supposed therapeutic effect could be secondary to an expectancy effect, to the natural course of disease or to spontaneous remission. As reported previously, the placebo effect of BoNT/A for primary headache disorders [26][27][28][29][30] has never reached efficacy rates as high as those described for BoNT/A for TN, even in reports of open-label trials 32 , when this effect is expected to be even higher.…”

Section: Further Comments On Placebo and Therapeutic Response In Tnmentioning

confidence: 96%

OnabotulinumtoxinA for trigeminal neuralgia: a review of the available data

Kowacs

Utiumi

Nascimento

et al. 2015

Arq. Neuro-Psiquiatr.

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Trigeminal neuralgia (TN) is a unilateral disorder characterized by brief electric-shock-like attacks of pain, abrupt in onset and termination and limited to the distribution of one or more divisions of the trigeminal nerve 1 . It is reported to have a prevalence of 0.1-0.2 per thousand and an incidence ranging from about 2 to 7.1/100 000/year and extending up to 20/100 000/year in individuals over 60 years of age. The condition is more common in women than in men (ratio 3:2) 2 . Treatment includes pharmacological therapy, usually with membrane stabilizers; invasive or minimally-invasive (mainly percutaneous procedures) surgical therapies; and radiosurgery 3 . In 2005, OnabotulinumtoxinA (BoNT/A) was reported to be effective for cases of TN that failed to respond to other therapies 4 . The therapeutic effect of BoNT/A in TN was first mentioned after a serendipitous finding by Wang and Jankovic 5. Reporting a case similar to the one that motivated a previous study by our group 4 , Jankovic described a patient who presented with hemifacial spasm and TN whose TN improved after treatment of the hemifacial spasm with BoNT/A. Since then, case reports and case series have been published in neurology, headache, pharmacology and pain medicine journals 6,7,8,9,10,11,12,13,14 . This literature, although suggesting the therapeutic effects of BoNT/A in TN, has been challenged 15 or even ignored by panels of experts 16,17 . The present review was undertaken to give readers an overview of the available evidence that BoNT/A has a therapeutic effect on TN. AbstrActTrigeminal neuralgia (TN) patients may develop side effects from centrally acting drugs, have contraindications for neurosurgical procedures, or experience relapse during conventional therapies. OnabotulinumtoxinA (BoNT/A) has been reported to be effective for TN, although this finding has been challenged. An overview of the available evidence based on a narrative/qualitative analysis of the literature is presented. About 90% of patients who receive BoNT/A show an improvement, a higher figure than that reported for the placebo effect of BoNT/A for other headaches. Tolerability of BoNT/A is good, and its few side-effects are transient. The articles reviewed were mainly case reports, case series and open-label trials; however, randomized controlled trials have endorsed the efficacy of BoNT/A for TN. This evidence, together with a better understanding of the analgesic mechanisms of BoNT/A and its proven efficacy in treating other pain syndromes, supports the use of this toxin as a therapeutic option for TN.Keywords: trigeminal neuralgia, botulinum neurotoxin type A, botulinum-A toxin, onabotulinumtoxinA, neuropathic pain. resumO Pacientes com neuralgia do trigêmeo (NT) podem apresentar efeitos colaterais decorrentes do uso de drogas psicoativas, contra-indicações a procedimentos neurocirúrgicos ou perda da eficácia destas terapias. A neurotoxina botulínica do tipo A (NTB/A) tem demonstrado ser eficaz no alívio da NT, ainda que este achado tenha sido contestado. Uma...

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Section: Further Comments On Placebo and Therapeutic Response In Tnmentioning

confidence: 96%

OnabotulinumtoxinA for trigeminal neuralgia: a review of the available data

Kowacs

Utiumi

Nascimento

et al. 2015

Arq. Neuro-Psiquiatr.

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“…The botulinum toxin is approved for the treatment of a chronic migraine, where it helps to reduce the excessive muscular tonus (in this manner it is also used in psychiatry), it also has a direct systemic reduction effect on migraine which provides an alternative non-cholinergic mechanism of action. 10 A successful therapy is subject to a complex differential diagnosis, where it is necessary to rule out other causes. A variety of pain in the head and neck should, therefore, be assessed by all specialists involved -a neurologist, an orthopedist, a spinal specialist, a-ENT specialist, a psychiatrist and last but not least, an oral surgeon.…”

Section: Botulotoxin and Dentistrymentioning

confidence: 99%

Effective applications of botulinum toxin in dentistry and in head and neck surgery

Smucler¹,

Jenča²,

Jenčová³

2017

EDUJ

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Cite this article:Šmucler R, Jenča A, Jenčova J. Effective applications of botulinum toxin in dentistry and in head and neck surgery. Stoma Edu J. 2017;4(3):200-207.Background: Botulinum toxin A and B is approved for the treatment of many diseases, and we can read many papers experimenting with other possibilities. The use of botulinum toxin is a relatively new option with little or no pre-gradual training in dentistry. Objective: This article aims to summarise current knowledge in this emerging field. Data Sources: A search of MEDLINE, EMBASE, bibliographies of published systematic reviews was performed, as well as of the Cochrane trial registries between 1966 and June 10, 2016. Study Selection: Randomized controlled trials comparing botulinum toxin A with placebo or other interventions were preferred, but for many emerging indication we used non-randomized studies as well to inspire further studies. Data Extraction: Data were abstracted and quality assessed by 1 reviewer. Data Synthesis: We have little-randomised data to quantify the effect of botulinum toxin in a majority of indications in dentistry precisely. Conclusion:The rapid development of the botulinum toxin application brings new possibilities for treatment by dentists alone or in cooperation with other specialists. Besides the above-verified evidencebased indications, there are new and new case studies quickly appearing that need to be monitored and possibly applied. But we have very few randomised studies to make final guidelines in many indications, so further scientific works are really needed. Botulinum toxin should be part of undergraduate and postgraduate teaching.

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“…In tra der mal inji ziert löst Cap sai cin eine star ke, aber nur kurz an hal ten de Schmerz re ak ti on aus. Dau er behand lung mit nied rig do sier ter Cap sai cin-Sal be (0,075) führ te über einen Zeit raum von 6 Wo chen zu ei ner sig ni fi kan ten Er hö hung der Wär me schmerz schwel le bei Ge sun den [1]. Ziel der ak tu el len Stu die ist es, die Wir kung ei ner hoch do sier ten Cap sai cin-Sal be (10) nach nur 24-stün di ger Ap pli ka ti on auf die ther mi schen Emp fi n dungs-und Schmerz schwel len zu un ter su chen.…”

Section: Hoch Do Sier Te Cap Sai Cin-sal Be üBer 24 H De Sen Si Bi LIunclassified

“…In ten siv me di zin, Me di zi ni sche Uni ver si tät Inns bruck Seit den 1970er Jah ren -mit der Be schrei bung von Opioidre zep to ren im Ge hirn und im Rücken mark -wur de ver mehrt über den pe ri ope rati ven Ein satz neu roaxia ler An al ge sie bei ver schie de nen Ein griff en und Al ters grup pen be rich tet. Die se ad ju van te An al ge sie, die so wohl int raals auch post ope ra tiv eine lan gan hal ten de, aus ge zeich ne te Schmerzthe ra pie ge währ leis tet, wur de vor al lem bei kar dio chir ur gi schen und or tho pä di schen Ein griff en bei Klein kin dern bis zu Er wach se nen an gewandt [1][2][3]. Auf Grund der phar ma ko ki ne ti schen Be son der hei ten der ge bräuch li chen Opioide (Li po phi lie) kann mit Fen ta nyl oder Suf en tanil eine rasch ein set zen de, aber kurz wirk sa me An al ge sie für die in traope ra ti ve Pha se, mit Mor phin hin ge gen eine für ca.…”

Section: Me DI Ka Men Tö Se Stra Te Gi En Bei Kreuz Schmer Zen Hg Kunclassified

Die 13. wissenschaftliche Jahrestagung der Österreichischen Schmerzgesellschaft

2005

Schmerz

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Di e Ös ter rei chi sche Schmerz ge sell schaft hat auf ih rer letz ten Ge ne ral ver samm lung im Rah men der 13. Ta gung in Inns bruck einen neu en Vor stand ge wählt: Prä si dent ist der Lei ter des In ter dis zi pli nären Schmerzzen trums Kla gen furt, Univ.-Doz. Dr. Rudolf Li kar, zum Se kre tär wur de der Salz burger Schmerz for scher Univ.-Prof. Dr. Gün-ther Ber natz ky ge wählt. Zum Prä si dent 1. Tref fen und Ko ope rie ren mit an de ren Fach ge sell schaf ten, um noch mehr fach über grei fend in ge mein sa men Aktio nen die Schmerz the ra pie zu ver bessern. 2. Verstärkte Gründung von Schmerz ambu lan zen und Qualitätssicherung. Neu er Vor stand der ÖSG ab Mai 2005Prä si dent Univ.-Doz. Dr. Rudolf Likar Lei ter Schmerz kli nik am LKH Kla gen furt 9020 Kla gen furt 0463/538-23720 Prä si dent (past) Prof. Dr. Eck hard Beubler In sti tut für exp. und klin. Phar ma ko lo gie 8010 Graz 0316/380-4309 Prä si dent (elect) Prof. Dr. Mi cha el Bach LNK Wag ner-Jau regg, Abt. für Psy chi at rie 4 4020 Linz 0732/6921-26811 Se kre tär Prof. Dr. Gün ther Ber natz ky Na tur wis sen schaft li che Fa kul tät der Uni ver sität Salz burg 5023 Salz burg 0662/8044-5627 Kas sie rer Prof. Dr. Joachim Maly Univ.-Kli nik für Neu ro lo gie 1090 Wien 01/40400-3106 Bei rat Dr. Mi cha el Aus ser wink ler 9020 Kla gen furt 0699/11107760 Prof. Dr. Hans Ge org Kress Univ.-Kli nik für An äs the sie und Allg. In ten siv medi zin (B) 1090 Wien 01/40400-4144 Prof. Dr. Jür gen Sand küh ler In sti tut für Hirn for schung der Uni ver si tät Wien 1090 Wien 01/4277-62834 OA Dr. Mar kus Han na Or thopädis ches Spi tal 1134 Wien 01/80182 OA Dr. Chris tian Lam pl Abt. für Neu ro lo gie des KH Linz 4020 Linz 0732/7806-2410 EOA Dr. Mar tin C. Spendel Abt. für Neu ro chir ur gie des LKH Kla gen furt 9020 Kla gen furt 0463/538-24353 Prim. Prof. Dr. Wil fried Il ias KH der Barm her zi gen Brü der 1021 Wien 01/21121-379 Prim. Dr. Jo sef F. Ma cher Dia ko nis sen kran ken haus Linz 4020 Linz 0732/7675-300 Univ.-Prof. Dr. Pe ter Wes se ly Univ.-Kli nik für Neu ro lo gie 1090 Wien 01/40400-3135 Prim. Dr. Bert hold Kepp lin ger NÖ Lan des ner ven kli nik Mau er 3362 Mau er bei Ams tet ten 07475/3233-499 Prof. Ing. Dr. An dre as Schla ger Univ.-Kli nik für An äs the sie und Allg. In ten sivme di zin 6020 Inns bruck 0512/504-22400 oder 22462 Prim. Prof. Dr. Al fred Witz mann Abt. für Neu ro chir ur gie des LKH Feld kirch 6807 Feld kirch 05522/303-1850 elect (Prä si dent in 2 Jah ren) wur de der Psych ia ter Univ.-Prof. Dr. Mi cha el Bach aus Steyr ge wählt. Als neue Bei rats mit glieder wur den der Inns bru cker Lei ter der Schmerz am bu lanz Univ.-Prof. Dr. An dre as Schla ger und der Kla gen fur ter Neu ro chirurg EOA Dr. Mar tin C. Spen del ge wählt. Herr Doz. Li kar stell te sei ne Zie le für sei ne Zeit als Prä si dent vor: Mitteilungen der Österreichischen Schmerzgesellschaft 337 Der Schmerz 4 · 2005 |dürf nis se des nie der ge las se nen Arz tes eingeht, und ein ein tä gi ges Pfle ge sym po si um ab ge hal ten.Wei ters konn ten auch bei die ser Tagung...

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Botulinum toxin in the treatment of rare head and neck pain syndromes: a systematic review of the literature

Cited by 38 publications

References 41 publications

OnabotulinumtoxinA for trigeminal neuralgia: a review of the available data

OnabotulinumtoxinA for trigeminal neuralgia: a review of the available data

Effective applications of botulinum toxin in dentistry and in head and neck surgery

Die 13. wissenschaftliche Jahrestagung der Österreichischen Schmerzgesellschaft

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