Botulinum toxin treatment of pain syndromes –an evidence based review. (1st June 2018)

• Record Type: Journal Article
• Authors: Safarpour, Yasaman; Jabbari, Bahman
• Is Part Of: Toxicon. Volume 147(2018)
• Page Start: 120
• Page End: 128
• Publication Date: 2018-06-01
• Subjects: Botulinum toxin -- Neuropathic pain -- Trigeminal neuralgia -- Post-herpetic neuralgia -- Post-traumatic neuralgia -- Diabetic neuropathy; Toxins -- Periodicals; Venom -- Periodicals; 615.9
• DOI: 10.1016/j.toxicon.2018.01.017
• Languages: English
• ISSNs: 0041-0101

Abstract

Abstract: This review evaluates the existing level of evidence for efficacy of BoNTs in different pain syndromes using the recommended efficacy criteria from the Assessment and Therapeutic Subcommittee of the American Academy of Neurology. There is a level A evidence (effective) for BoNT therapy in post-herpetic neuralgia, trigeminal neuralgia, and posttraumatic neuralgia. There is a level B evidence (probably effective) for diabetic neuropathy, plantar fasciitis, piriformis syndrome, pain associated with total knee arthroplasty, male pelvic pain syndrome, chronic low back pain, male pelvic pain, and neuropathic pain secondary to traumatic spinal cord injury. BoNTs are possibly effective (Level C -one class II study) for female pelvic pain, painful knee osteoarthritis, post-operative pain in children with cerebral palsy after adductor release surgery, anterior knee pain with vastus lateralis imbalance. There is a level B evidence (one class I study) that BoNT treatment is probably ineffective in carpal tunnel syndrome. For myofascial pain syndrome, the level of evidence is U (undetermined) due to contradicting results. More high quality (Class I) studies and studies with different types of BoNTs are needed for better understanding of the role of BoNTs in pain syndromes. Highlights: The Author evaluated the published evidence on use of BoNT for Pain syndromes. Eighteen pain syndromes are included in this evaluation. The strength of evidence and efficacy is presented according to the AAN classification scale.