Conclusion Based on the current evidence , BTX-A may be an effective and safe option for the treatment of neuralgia .
Aim This meta- analysis was performed to evaluate the efficacy and safety of botulinum toxin-A ( BTX-A ) for the treatment of neuralgia .
A Prospective Randomized Double-blinded Pilot Study to Examine the Effect of Botulinum Toxin Type A Injection Versus Lidocaine/Depomedrol Injection on Residual and Phantom Limb Pain: Initial Report
Objective Botulinum toxin type A ( Botox ) injection has been used to manage pain . However , it remains to be proved whether Botox injection is effective to relieve residual limb pain ( RLP ) and phantom limb pain ( PLP ) . Design R and omized , double-blinded pilot study . Setting Medical College and an outpatient clinic in Department of Physical Medicine and Rehabilitation . Participants Amputees ( n=14 ) with intractable RLP and /or PLP who failed in the conventional treatments . Interventions Study amputees were r and omized to receive 1 Botox injection versus the combination of Lidocaine and Depomedrol injection . Each patient was evaluated at baseline and every month after the injection for 6 months . Main Outcome MeasureThe changes of RLP and PLP as recorded by VAS , and the changes of the pressure pain tolerance as determined by a pressure algometer . Results All patients completed the protocol treatment without acute side effects , and monthly assessment s of RLP , PLP , and pain tolerance after the treatment . The time trend in the outcomes was modeled as an immediate change owing to the treatment followed by a linear tread afterward . Repeated measures were incorporated using mixed effects modeling . We found that both Botox and Lidocaine/Depomedrol injections result ed in immediate improvements of RLP  ( Botox : P=0.002 ; Lidocaine/Depomedrol : P=0.06 ) and pain tolerance  ( Botox : P=0.01 ; Lidocaine/Depomedrol : P=0.07 ) . The treatment effect lasted for 6 months in both groups . The patients who received Botox injection had higher starting pain than those who received Lidocaine/Depomedrol injection ( P=0.07 ) . However , there were no statistical differences in RLP and pain tolerance between these 2 groups . In addition , no improvement of PLP was observed after Botox or Lidocaine/Depomedrol injection . Conclusions Both Botox and Lidocaine/Depomedrol injections result ed in immediate improvement of RLP ( not PLP ) and pain tolerance , which lasted for 6 months in amputees who failed in conventional treatments
Conclusion Based on the current evidence , BTX-A may be an effective and safe option for the treatment of neuralgia .
Aim This meta- analysis was performed to evaluate the efficacy and safety of botulinum toxin-A ( BTX-A ) for the treatment of neuralgia .