Improvement of chronic facial pain and facial dyskinesia with the help of botulinum toxin application.
BACKGROUND
Facial pain syndromes can be very heterogeneous and need individual diagnosis and treatment. This report describes an interesting case of facial pain associated with eczema and an isolated dyskinesia of the lower facial muscles following dental surgery. Different aspects of the pain, spasms and the eczema will be discussed.


METHODS
In this patient, persistent intense pain arose in the lower part of her face following a dental operation. The patient also exhibited dyskinesia of her caudal mimic musculature that was triggered by specific movements. Several attempts at therapy had been unsuccessful. We performed local injections of botulinum toxin type A (BTX-A) into the affected region of the patient's face. Pain relief was immediate following each set of botulinum toxin injections. The follow up time amounts 62 weeks.


CONCLUSIONS
Botulinum toxin type A (BTX-A) can be a safe and effective therapy for certain forms of facial pain syndromes.
Junghans
Katharina
K
Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany. katharina.arnhold@medizin.uni-goettingen.de
Rohrbach
Saskia
S
Ellies
Maik
M
Laskawi
Rainer
R
Curr Probl Dermatol. 2002;30:236-45
12471716
Headache. 1999 Oct;39(9):662-5
11279962
J Neurol Neurosurg Psychiatry. 1990 Aug;53(8):633-9
2213039
Br J Hosp Med. 1994 Oct 5-18;52(7):363
7858823
Cephalalgia. 1998 Dec;18(10):709-11
9950630
J Neurol. 1992 Jan;239(1):1-4
1541963
Eur J Med Res. 1999 May 26;4(5):183-6
10336407
Curr Probl Dermatol. 2002;30:170-7
12471711
N Engl J Med. 1991 Apr 25;324(17):1186-94
2011163
Lancet. 1986 Aug 2;2(8501):245-7
2874278
J Pain. 2002 Feb;3(1):21-7
14622850
Ann Neurol. 1995 Aug;38(2):139-40
7654059
Oral Surg Oral Med Oral Pathol. 1983 Apr;55(4):355-8
6574413
J Orofac Pain. 2006 Winter;20(1):24-30
16483017
Arch Neurol. 1984 Nov;41(11):1204-7
6487105
Pain. 1994 Oct;59(1):65-9
7854804
Microsurgery. 1994;15(8):527-33
7830533
Curr Rev Pain. 1999;3(6):427-431
10998700
Oral Surg Oral Med Oral Pathol. 1985 May;59(5):472-4
3859806
J Oral Maxillofac Surg. 2003 Jul;61(7):774-8
12856249
Schmerz. 2003 Apr;17(2):149-65
12695898
Acta Otolaryngol. 1993 May;113(3):400-4
8390772
Neurol Clin. 1990 Nov;8(4):913-28
2259319