Contribution of Botulinum Toxin for the Treatment of Neuropathic Pain.
Keywords:
Neuralgia, Botulinum toxins, TherapeuticsAbstract
Neuropathic pain is caused by an injury or a disease of the somatosensory system, including peripheral nerve fibres and central neurons. Botulinum toxin (BTX) is a neurotoxic protein produced by the bacterium Clostridium botulinum. BTX interferes with the release of the neurotransmitter acetylcholine from neuroaxon terminals at the neuromuscular synapse and thus causes flaccid paralysis. This literature review investigates the recent data regarding the efficacy of BTX in the treatment of various forms of neuropathic pain. A total of 18 original clinical trials published after 2010 were selected, 12 of which were randomized controlled studies, one was a non-randomized controlled study and the remaining 5 were case series. A total of 1,131 patients were enrolled. BTX represents an effective treatment for neuropathic pain. Further randomised controlled trials are needed to demonstrate treatment efficacy, provide guidelines in relation to its application protocols and establish possible treatment variations at different sub-groups of patients.
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