Botulinum toxin can ease intense facial pain

There is another use for botulinum toxin which has brought relief to some who suffer from migraines and eye spasms. Botulinum toxin can also successfully treat intense facial pain called trigeminal neuralgia, according to a study published in the October 25, 2005, issue of Neurology, the scientific journal of the American Academy of Neurology.

Trigeminal neuralgia is a disorder characterized by sudden, severe, stabbing, or shock-like pain usually felt on one side of the jaw or cheek. The pain lasts several seconds and could be repeated in a series of attacks. Activities like talking, brushing teeth, or swallowing can trigger an attack. Also called tic douloureux, the disorder is more common in women than in men and typically affects those older than 50. Anticonvulsant medication has been a main course of treatment. In some cases, surgery is an option.

Researchers in Brazil and the United States studied the effects of botulinum toxin type A in 13 patients with trigeminal neuralgia. Pain significantly decreased in all patients 10 days following the injection. After 20 days, they were almost symptom-free.

By 60 days, four patients had become medication-free, and the others reduced their medication use by more than 50 percent.

“Drugs are not always effective in treating trigeminal neuralgia. Some patients avoid them because of side effects, and then their pain is more intense and longer-lasting,” said Elcio Juliato Piovesan, MD, a neurologist at the Hospital of Clinics at Federal University of Parana in Curitiba, Brazil.

There were no major side effects from botulinum toxin observed in the 13 patients.

“A placebo-controlled clinical trial is needed to confirm our findings, including a follow-up period longer than 60 days,” said Piovesan.