title: Botulinum toxin type A for neuropathic pain in patients with spinal cord injury.
abstract: OBJECTIVE
  To evaluate the analgesic effect of botulinum toxin type A (BTX-A) on patients with spinal cord injury-associated neuropathic pain.
  
  
  METHODS
  The effect of BTX-A on 40 patients with spinal cord injury-associated neuropathic pain was investigated using a randomized, double-blind, placebo-controlled design. A 1-time subcutaneous BTX-A (200U) injection was administered to the painful area. Visual analogue scale (VAS) scores (0-100mm), the Korean version of the short-form McGill Pain Questionnaire, and the World Health Organization WHOQOL-BREF quality of life assessment were evaluated prior to treatment and at 4 and 8 weeks after the injection.
  
  
  RESULTS
  At 4 and 8 weeks after injection, the VAS score for pain was significantly reduced by 18.6 ± 16.8 and 21.3 ± 26.8, respectively, in the BTX-A group, whereas it was reduced by 2.6 ± 14.6 and 0.3 ± 19.5, respectively, in the placebo group. The pain relief was associated with preservation of motor or sensory function below the neurological level of injury. Among the responders in the BTX-A group, 55% and 45% reported pain relief of 20% or greater at 4 and 8 weeks, respectively, after the injection, whereas only 15% and 10% of the responders in the placebo group reported a similar level of pain relief. Improvements in the score for the physical health domain of the WHOQOL-BREF in the BTX-A group showed a marginal trend toward significance (p = 0.0521) at 4 weeks after the injection.
  
  
  CONCLUSIONS
  These results indicate that BTX-A may reduce intractable chronic neuropathic pain in patients with spinal cord injury.
authors.affiliation: Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, South Korea.
authors.forename: Zee-A
authors.initials: ZA
authors.lastname: Han
authors.affiliation: Department of Rehabilitation Medicine, St Paul's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Dae Heon
authors.initials: DH
authors.lastname: Song
authors.affiliation: Department of Rehabilitation Medicine, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Hyun-Mi
authors.initials: HM
authors.lastname: Oh
authors.affiliation: Department of Rehabilitation Medicine, St Paul's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
authors.forename: Myung Eun
authors.initials: ME
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000494:pharmacology*; D059350:Chronic Pain / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000494:pharmacology*; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D013119:Spinal Cord Injuries / Q000150:complications*; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
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