title: Topical Review: Potential Use of Botulinum Toxin in the Management of Painful Posttraumatic Trigeminal Neuropathy.
abstract: Painful posttraumatic trigeminal neuropathy (PPTTN) is a chronic condition that is difficult to endure and has a poorly understood pathophysiology. Treatment options are limited and often unsatisfactory due to insufficient efficacy and significant adverse effects. Botulinum toxin type A (BTX-A), initially used in the management of pathologically sustained or twisting muscular contractions, has recently been advocated for treatment of neuropathic pain. Its action is not limited to the blockage of acetylcholine release at the neuromuscular junction, but also includes inhibition of exocytosis of other neurotransmitters by interfering with the SNARE complexes of synaptic membranes. When injected into the painful location, the toxin can be taken up by peripheral terminals of nociceptive afferent nerve fibers, and this action suppresses peripheral and central release of algogenic neurotransmitters such as glutamate or substance P, thus promoting analgesia. Several randomized controlled trials in humans have provided emerging evidence for the therapeutic use of BTX-A in neuropathic pain states, including trigeminal neuralgia. This evidence, in addition to its good safety profile and long-lasting effect, suggests that BTX-A could be a potential novel treatment for PPTTN.
authors.forename: Nathan
authors.initials: N
authors.lastname: Moreau
authors.forename: Wisam
authors.initials: W
authors.lastname: Dieb
authors.forename: Vianney
authors.initials: V
authors.lastname: Descroix
authors.forename: Peter
authors.initials: P
authors.lastname: Svensson
authors.forename: Malin
authors.initials: M
authors.lastname: Ernberg
authors.forename: Yves
authors.initials: Y
authors.lastname: Boucher
mesh_terms: D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D005151:Facial Injuries / Q000150:complications*; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D013122:Spinal Diseases / Q000188:drug therapy; D014277:Trigeminal Neuralgia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
chemical_list: D019274:Botulinum Toxins, Type A