title: Botulinum toxin for neuropathic pain and spasticity: an overview.
abstract: In recent years, a large body of data has surfaced reporting the therapeutic benefit of botulinum toxin injection in multiple conditions. The aim of this review is: to summarize the highest quality literature pertaining to clinical application of botulinum toxin in neuropathic pain conditions including postherpetic neuralgia, trigeminal neuralgia, diabetic polyneuropathy, post-traumatic neuralgia, carpal tunnel syndrome, complex regional pain syndrome, phantom limb and stump pain, and occipital neuralgia; to provide an overview of the clinical trials using botulinum toxin in adult spasticity; and to assign levels of evidence according to the American Academy of Neurology guidelines. In summary, there is level A evidence for established efficacy in postherpetic neuralgia and adult spasticity; level B evidence for probable efficacy in trigeminal neuralgia and post-traumatic neuralgia; level B evidence for probable lack of efficacy in carpal tunnel syndrome; level C evidence for possible efficacy in diabetic polyneuropathy; and level U (insufficient) evidence in complex regional pain syndrome, phantom limb and stump pain, and occipital neuralgia.
authors.affiliation: Department of Neurology, Mount Sinai Medical Center, Box 1052, New York, NY 10029, USA.
authors.forename: E Alexandra
authors.initials: EA
authors.lastname: Brown
authors.forename: Sonja G
authors.initials: SG
authors.lastname: Schütz
authors.forename: David M
authors.initials: DM
authors.lastname: Simpson
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy*; D009437:Neuralgia / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D001905:Botulinum Toxins