The Analgesic Effect of Abobotulinum and Incobotulinum Toxins Type A in Central Poststroke Pain: Two Case Reports

Camões-Barbosa, Alexandre; Neves, A.F.

doi:10.1016/j.pmrj.2015.12.002

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…Barbosa et al also published a case report in which an analgesic effect was obtained using BoNT-A in patients with central poststroke pain. In two patients with stroke, injection of BoNT-A 200 U into the affected area under EMG guidance resulted in a decrease in NRS after a 3-month follow-up [ 64 ]. A randomized, double-blind, placebo-controlled trial of 273 patients with poststroke spasticity was performed.…”

Section: Clinical Study Of Botulinum Toxin For Neuropathic Painmentioning

confidence: 99%

Botulinum Toxin for the Treatment of Neuropathic Pain

Park

2017

Toxins

180

111

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Botulinum toxin (BoNT) has been used as a treatment for excessive muscle stiffness, spasticity, and dystonia. BoNT for approximately 40 years, and has recently been used to treat various types of neuropathic pain. The mechanism by which BoNT acts on neuropathic pain involves inhibiting the release of inflammatory mediators and peripheral neurotransmitters from sensory nerves. Recent journals have demonstrated that BoNT is effective for neuropathic pain, such as postherpetic neuralgia, trigeminal neuralgia, and peripheral neuralgia. The purpose of this review is to summarize the experimental and clinical evidence of the mechanism by which BoNT acts on various types of neuropathic pain and describe why BoNT can be applied as treatment. The PubMed database was searched from 1988 to May 2017. Recent studies have demonstrated that BoNT injections are effective treatments for post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia, and intractable neuropathic pain, such as poststroke pain and spinal cord injury.

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Section: Clinical Study Of Botulinum Toxin For Neuropathic Painmentioning

confidence: 99%

Botulinum Toxin for the Treatment of Neuropathic Pain

Park

2017

Toxins

180

111

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“…This has been reported in a report of two cases in which the patients also experienced an unexpected reduction in CPSP post botulinum toxin. However this was improvement lessened with time and analgesia on repeat therapies was not reported [3]. This case demonstrates a clear long term improvement in a neuropathic pain sensation, which was independent from the improvement in spasticity.…”

Section: Introductionmentioning

confidence: 71%

Untitled

2017

JNSK

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Purpose: Spasticity and pain are common complications of stroke. Pain following stroke is multi factorial and can be due to musculoskeletal problems, painful spasticity or central post stroke pain. Botulinum Toxin A is the first line pharmacotherapy in spasticity management and increasing evidence has shown benefits in neuropathic pain.Results: This case report demonstrates the benefit of Botulinum Toxin A in the management of central post-stroke pain with elbow flexor spasticity. The clinical characteristics of the pain were neuropathic and the severity was greater than expected given the degree of spasticity. The pain responded to Botulinum Toxin treatment within a few days, independently of the improvement in spasticity and the effect was continued over six cycles of treatment. Conclusion:Management of central post stroke pain is challenging due systemic side effects of oral medications. Botulinum Toxin A has increasingly being shown to benefits in neuropathic pain either through blockade of nociceptive substances or acting on central transmission of pain. Although the treatment in our case was given for spasticity management, the patient had unexpected and significant improvement in pain prior to improvement in range of movement. Given the increasing evidence in use of Botulinum Toxin A in neuropathic pain, we feel this may be a possible future treatment option for central post-stroke pain

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“…One major limitation is the use of different toxin serotypes and preparations which hampers the comparison of studies' results. Most studies specified the use of the common BoNT/A brand (Botox®) ( 27 , 29 , 32 , 34 , 36 , 40 , 43 , 44 , 52 , 55 , 67 – 71 , 74 , 77 , 84 , 89 , 90 , 93 , 101 ) or other BoNT/A compounds (e.g., HengLi®, Meditoxin®, Disport®) ( 33 , 38 , 39 , 41 , 50 , 62 , 72 , 94 , 96 ), but, in many cases, no specification of the BoNT/A serotype was provided ( 27 , 31 , 35 , 37 , 42 , 47 , 51 , 53 , 54 , 60 , 61 , 66 , 75 , 78 , 83 , 85 , 86 , 94 , 102 – 104 ). Furthermore, two studies were performed with botulinum toxin type B ( 73 , 87 ) and two with incobotulinum toxin type A ( 76 , 88 ).…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of BoNT/A in central PSP control has been investigated (Table 3) (66)(67)(68)(69). A prospective RCT performed on 37 patients failed to demonstrate any BoNT/A efficacy on PSP (68).…”

Section: Post-stroke Pain (Psp)mentioning

confidence: 99%

Botulinum Neurotoxin for the Treatment of Neuropathic Pain

2020

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Botulinum neurotoxin is widely used for the treatment of central and peripherical neurological conditions. Initially used to treat strabismus, over the years its use has been expanded also to spasticity and other neurological disorders. This review summarizes the evidence from the published literature regarding its effect on neuropathic pain. Almost all investigations were performed using onabotulinum toxin type A (BoNT/A). Most studies provided positive results, even though toxin formulation, dose, dilution, injection techniques, and sites are heterogeneous across studies. Future larger, high-quality, specifically designed clinical trials are warranted to confirm botulinum neurotoxin efficacy in neuropathic pain.

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The Analgesic Effect of Abobotulinum and Incobotulinum Toxins Type A in Central Poststroke Pain: Two Case Reports

Cited by 6 publications

References 15 publications

Botulinum Toxin for the Treatment of Neuropathic Pain

Botulinum Toxin for the Treatment of Neuropathic Pain

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Botulinum Neurotoxin for the Treatment of Neuropathic Pain

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