Subcutaneous botulinum toxin for chronic post-thoracotomy pain.
OBJECTIVE
Botulinum toxin is a neurotoxin that has been widely used in chronic pain for the treatment of multiple conditions with a component of localized muscle spasm. Recent studies suggest that botulinum toxin is effective in the treatment of neuropathic pain syndromes such as post-herpetic neuralgia.


METHODS
We report the case of a 67-year-old man who underwent atypical segmentectomy of a right lower lobe lung nodule. The patient was referred to our pain management department with a of 2-year history persistent pain along the thoracotomy scar having a predominantly neuropathic component, refractory to standard treatments. He was successfully treated with subcutaneous botulinum toxin type A.


CONCLUSIONS
On the basics of our own experience and on the analysis of the reports published in the literature, fractioned subcutaneous injections of botulinum toxin may be useful for the treatment of various chronic localized pain conditions including chronic post-thoracotomy pain.
Department of Multidisciplinary Pain Management, General University Hospital, Valencia, Spain. gfabregat@gmail.com
Gustavo
G
Fabregat
Juan M
JM
Asensio-Samper
Stefano
S
Palmisani
Vicente L
VL
Villanueva-Pérez
José
J
De Andrés
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D006801:Humans; D007279:Injections, Subcutaneous; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D013908:Thoracotomy / Q000009:adverse effects*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A