The efficacy of botulinum toxin for the treatment of trigeminal and postherpetic neuralgia: a systematic review with meta-analyses.
OBJECTIVE
To evaluate the efficacy of a botulinum toxin type A (BoTN-A) in treating trigeminal neuralgia (TN) and postherpetic neuralgia (PHN).


METHODS
Three databases were searched: Medline, Web of Science, and Cochrane Library. The search was restricted to English-language randomized, placebo-controlled trials. Three review authors evaluated the cases for risk of bias.


RESULTS
Six studies were eligible for inclusion. Pooled results showed a difference in post-treatment pain intensity of -3.009 (95% confidence interval -4.566 to -1.453; P < .001) in favor of BoTN-A compared with placebo in managing TN or PHN. Of the six studies, five had unclear risk of bias, and one showed high risk.


CONCLUSIONS
Although the studies had unclear or high risk of bias, moderate evidence regarding the efficacy of BoTN-A in treating TN and PHN was found. BoTN-A might be an alternative treatment to those patients who are either unable to manage their pain medically or would like adjunct therapy.
Graduate, Master Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Thomas
T
Shackleton
Associate Professor of Clinical Dentistry, Program Director, Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Saravanan
S
Ram
Graduate, Master Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Misty
M
Black
Graduate, Master Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Jon
J
Ryder
Professor of Dentistry, Program Director, Orofacial Pain, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
Glenn T
GT
Clark
Associate Professor of Clinical Dentistry, Herman Ostrow School of Dentistry of USC, Los Angeles, CA, USA. Electronic address: Renciso@usc.edu.
Reyes
R
Enciso
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D006801:Humans; D051474:Neuralgia, Postherpetic / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D059408:Pain Management; D014277:Trigeminal Neuralgia / Q000188:drug therapy*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A