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 .
Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study.
OBJECTIVE To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A ( BTX-A ) in providing significant and prolonged pain relief in chronic occipital neuralgia . BACKGROUND Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions . Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve , myofascial spasm , and focal entrapment of the occipital nerve . Treatment options include medication therapy , occipital nerve blocks , and surgical techniques . BTX-A , which has shown promise in relief of other headache types , may prove a viable therapeutic option for occipital neuralgia pain . METHODS Botulinum toxin type-A ( reconstituted in 3 cc of saline ) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia . Subjects were instructed to report their daily pain level ( on a visual analog pain scale ) , their ability to perform daily activities ( on several quality of life instruments ) and their daily pain medication usage ( based on a self-reported log ) , 2 weeks prior to the injection therapy and 12 weeks following injection therapy . Data were analyzed for significant variation from baseline values . RESULTS The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period . The sharp/shooting type of pain , however , showed improvement during most of the trial period except weeks 3 - 4 and 5 - 6 . The quality of life measures exhibited some improvement . The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12 . The general health- and depression-related measures showed no statistical improvement . No significant reduction in pain medication usage was demonstrated . CONCLUSIONS Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia . Additionally , the quality of life measures assessing burden and long-term impact of the headaches , further corroborated improvement seen in daily head pain
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 .