Treatment of occipital neuralgia using onabotulinum toxin A

Abstract

Objectives To determine the effectiveness of botulinum toxin in a sample of patients diagnosed with greater occipital nerve neuralgia. Material and Methods Twenty‐nine patients (28 females, 1 male) were treated for greater occipital nerve neuralgia with onabotulinum toxin type A; the Visual Analog Pain Scale was used to determine pain severity at treatment and again 12 weeks after application. Results Average doses of onabotulinum toxin type A of 18.66±6.44 U per nerve and 35.96±12.89 U per patient were utilized. Average pain severity among the sample was 9.81±0.89 prior to botulinum toxin application and 3.68±2.31 points (p<0.0001) twelve weeks after application. Pain frequency decreased from 29.93±0.37 to 12.17±11.05 days with pain per month (p<0.0001). Six patients reported absence of pain after application (p=0.023). Dose did not correlate with the degree of clinical response observed, and no side effects were reported. Conclusion Our findings suggest onabotulinum toxin type A is a safe and effective treatment alternative for patients suffering from refractory greater occipital nerve neuralgia.

The Use of Botulinum Toxin Type A in Medically Refractory Pediatric Patients With Chronic Daily Headaches and Its Impact on the Quality of Life

“…Lidocaine injections, commonly used in adults, may have more side effects in the pediatric population, making Botox a potentially safer alternative. 27 New daily persistent headaches (NDPH) are another challenging subtype of chronic daily headaches encountered in pediatric patients, and further research is needed to investigate the effectiveness of Botox or lidocaine injections for managing new daily persistent headaches.…”

Perineural injections of incobotulinumtoxin-A for diabetic neuropathic pain of the lower extremities: protocol for a phase II, single-centre, double-blind, randomised, placebo-controlled trial (the PINBOT study)

“…21 For occipital neuralgia, several smaller case reports have reported significant pain relief, with no adverse events. [22][23][24] This paper describes the protocol and presents the rationale for an adequately powered, double-blind, randomised, placebo-controlled study. The current phase II trial represents the largest RCT investigating perineural BonT-A, and the first in this patient group.…”

“…32 It consists of a 21-question multiple-choice self-report inventory covering different mental and physical symptoms related to depression, each rated on a 4-point scale (0-3) of severity. The final score is denoted as the sum of the total severity ratings for each item, ranging from minimal symptoms (0-13), mild (14)(15)(16)(17)(18)(19), moderate (20)(21)(22)(23)(24)(25)(26)(27)(28) and severe .…”

“…The authors describe the treatment as safe, well tolerated and effective, with responders reporting sufficient pain relief for 3 to 4 months after injection 21. For occipital neuralgia, several smaller case reports have reported significant pain relief, with no adverse events 22–24…”