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 .
Clinically significant placebo analgesic response in a pilot trial of botulinum B in patients with hand pain and carpal tunnel syndrome.
OBJECTIVE We conducted a pilot trial to assess the effect of botulinum toxin B on  palmar pain and discomfort in carpal tunnel syndrome ( CTS ) patients . Design . R and omized , double-blind , placebo-controlled . PATIENTS Twenty ambulatory CTS patients . Intervention . Botulinum toxin B or placebo injections into three hypothenar muscles anatomically linked or attached to the carpal tunnel and its tentorium , that is , the Opponens Digiti Minimi and Flexor Digiti Minimi , located with electromyography ( EMG ) , and the Palmaris Brevis Muscle , anatomically located without EMG . SETTING New York City hospital . OUTCOME MEASURES Outcomes were measured with numeric ratings , with higher scores indicating worse outcomes . Daily , subjects recorded their 0 - 10 numeric ratings of overall pain levels and pain-related sleep disturbances . During weekly telephone calls , they reported their 0 - 10 ratings for overall pain , pain-related sleep disturbance , and CTS-related tingling during the night and day as experienced over the preceding 24 hours . For each of four clinic visits , we averaged each subject 's ratings of nine quality of life indicators from the West Haven-Yale Multidimensional Pain Inventory ( WHYMPI ) , each measured on a 0 - 6 numeric scale . RESULTS Over the 13-week trial , compared to baseline scores , the following outcomes predominantly showed decreases of statistical significance ( P < or = 0.050 ) or borderline significance ( 0.050 < P < or = 0.10 ) for weeks 2 through 8 : overall pain per daily diary entries and per weekly telephone reports , and pain-related sleep disturbance in the placebo group per phone report and in the botulinum toxin B group per diary report . CTS painful night tingling and day tingling , as well as the average scores of the WHYMPI quality of life indicators , showed improvements with statistical or borderline significance for almost each follow-up week . Between-group analyses , however , demonstrated that at each follow-up week , there was no statistically significant difference between the two study groups regarding changes from baseline in any study outcome . CONCLUSION Botulinum toxin B is not dramatically superior to placebo for the relief of CTS symptoms . Possible explanations of the improvements in each study group are explored
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 .