Botulinum toxin A for treatment of allodynia of complex regional pain syndrome: a pilot study.
OBJECTIVE
To investigate the efficacy and tolerability of Botulinum toxin A (BoNT-A) in allodynia of patients with complex regional pain syndrome.


METHODS
A total of 14 patients were studied. Eight patients were participants of a randomized, prospective, double-blind, placebo-controlled protocol. Six patients were studied prospectively in an open-label protocol. Patients were rated at baseline and at 3 weeks and 2 months after BoNT-A administration. Ratings included brief pain inventory, McGill pain questionnaire, clinical pain impact questionnaire, quantitative skin sensory test, sleep satisfaction scale, and patient global satisfaction scale. BoNT-A was injected intradermally and subcutaneously, five units/site into the allodynic area (total dose 40-200 units).


RESULTS
None of the patients with allodynia showed a significant response after treatment. The treatment was painful and poorly tolerated.


CONCLUSIONS
Intrademal and subcutaneous administration of BoNT-A into the allodynic skin of the patients with complex regional pain syndrome (CRPS) failed to improve pain and was poorly tolerated.
Safarpour
Delaram
D
Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA. delaram.safarpour@yale.edu
Salardini
Arash
A
Richardson
Diana
D
Jabbari
Bahman
B
D000328:Adult; D000818:Animals; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D020918:Complex Regional Pain Syndromes / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009498:Neurotoxins / Q000627:therapeutic use*; D010147:Pain Measurement; D017060:Patient Satisfaction; D010919:Placebos / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
D009498:Neurotoxins; D010919:Placebos; D019274:Botulinum Toxins, Type A