Abstract
Data sources
Medline via PubMed, the Web of Science and the Cochrane Library were searched until April 2014.
Study selection
Randomised controlled trials (RCTs) comparing the efficacy of botulinum toxin type A (BoTN-A) with placebo in patients with painful trigeminal (TN) and postherpetic neuralgia (PHN) reporting changes in pain intensity in patients aged 19 years and older available in English were included.
Data extraction and synthesis
Three authors independently assessed for inclusion, extracted standard data and assessed for risk of bias. The primary outcomes were baseline and post treatment intensity of pain and patients reporting pain relief of 50% or greater.
For continuous outcomes the treatment effect was measured as mean differences with 95% confidence intervals (CIs). For dichotomous outcome of reduction of pain of 50% or more, relative risk (risk ratio) with 95% CIs was reported. Statistical heterogeneity was tested with Cochran's test for heterogeneity and quantified by the I2 statistic. Results were combined using random-effects model in the presence of statistical heterogeneity otherwise fixed effect model was used.
Results
Six studies were included. The effects of the interventions were presented in three meta-analyses. Mean difference in post treatment pain (six studies) pooled results showed a reduction of −3.009 in the VAS (95% CI −4.566 to −1.453 p<0.001) with the use of BoTN-A. Standardised difference in mean post treatment pain (six studies) was −0.918 (95% CI −1.197 to −0.639 p<0.001) in favor of BoTN-A. For the percentage of patients experiencing 50% pain reduction (three studies) absolute risk difference and relative risk were calculated (RR 2.892, 95% CI 1.726 to 4.848 p<0.001) in favour of the use of BoTN-A.
Conclusions
The authors concluded that there is moderate evidence regarding the efficacy of BoTN-A in treating patients with trigeminal neuralgia and postherpetic neuralgia.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Gazerani P, Pederson NS, Staahl C, Drewes AM, Arendt-Nielsen L . Subcutaneous Botulinum toxin type A reduces capsaicin-induced trigeminal pain and vasomotor reactions in human skin. Pain 2009; 141: 60–69.
Author information
Authors and Affiliations
Additional information
Address for correspondence: Reyes Enciso, Associate Professor of Clinical Dentistry, Division of Dental Public Health and Pediatric Dentistry Herman Ostrow School of Dentistry of USC, 925 West 34th St. Room 4268, Los Angeles, CA 90089-0641, USA. E-mail: Renciso@usc.edu
Shackleton T, Ram S, Black M, Ryder J, Clark GT, Enciso R. The efficacy of botulinum toxin for the treatment of trigeminal and postherpetic neuralgia: a systematic review with meta-analyses. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122: 61–71.
Rights and permissions
About this article
Cite this article
Fischoff, D., Spivakovsky, S. Botulinum toxin for facial neuralgia. Evid Based Dent 19, 57–58 (2018). https://doi.org/10.1038/sj.ebd.6401310
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6401310
This article is cited by
-
Trigeminusneuralgie
DGNeurologie (2022)
-
Auf dem Weg zur optimierten Therapie der Trigeminusneuralgie
NeuroTransmitter (2018)
