Review Article, J Spine Neurosurg Vol: 5 Issue: 4
Botulinum Toxin In Trigeminal Neuralgia: Which is the Best Way of Delivery?
|Batifol D1 and Finiels PJ2*|
|1Maxillofacial Surgery and Stomatology Department, Montpellier University Hospital Centre, France|
|2Department of Orthopedic and Neurological Spine Surgery, Alès General Hospital, Alès, France|
|Corresponding author : Dr. Pierre-Jacques Finiels
Department of Orthopedic and Neurological Spine Surgery, Alès General Hospital, 811 Avenue du Docteur Jean Goubert, 30103 Alès Cedex, France
|Received: February 03, 2016 Accepted: April 20, 2016 Published: April 27,2016|
|Citation: Batifol D, Finiels PJ (2016) Botulinum Toxin In Trigeminal Neuralgia: Which is the Best Way of Delivery?. J Spine Neurosurg 5:4. doi:10.4172/2325-9701.1000226|
Context: Botulinum toxin has been widely shown to have analgesic effects independent of its action on muscle tone, mostly by acting on neurogenic inflammatory mediators and reducing the release of neurotransmitters at the sensory nerve or the autonomic nerve terminals. Objective: The aim of this study is to try and understand the differences that could exist between injecting the painful zone or injecting a possible trigger zone (TZ) in case of trigeminal neuralgia. Methods: 28 patients (26 female, 2 male), with an average age of 61 years (41-88 years), were injected with type A botulinum toxin, the dose which was used varied between 15 and 50 U Botox* . 16 (57%) were injected over the entire painful area and only 12 (43%) were injected in the TZ. Results: Overall, we can note an efficacy of 100% in the case of injection in the area of referred pain and 83% in the case of injection in the TZ alone, the calculation of the p-value in Fisher’s exact test showing no statistically significant difference between the two techniques. Conclusion: This study confirms the efficacy of the toxin and the lack of significant difference between injecting the painful zone or injecting a possible TZ. In this later case, treating it directly would seem to be the first choice, according to the average dose of botulinum toxin used.