Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200185
Brazilian Journal of Pain
Review Article

Botulinum toxin in pain management of trigeminal neuralgia: literature review

Toxina botulínica no tratamento da dor na neuralgia trigeminal: revisão de literatura

João Gabriel de Azevedo José Romero; Roberto Brígido de Nazareth Pedras; Camila Megale Almeida-Leite

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Abstract

BACKGROUND AND OBJECTIVES: Botulinum neurotoxin type A has been an interesting therapeutic complement to the conventional treatment of trigeminal neuralgia, especially in patients without satisfactory response to pharmacotherapy and/or surgical procedures. A detailed and comprehensive literature review its important for the description of the available evidence, allowing for a critical view on the topic. Therefore, this study's objective was to describe the scientific evidence on the use of botulinum toxin type A in the trigeminal neuralgia treatment.

CONTENTS: Pubmed and Scielo databases were searched using the descriptors: "trigeminal neuralgia and botulinum toxin". Inclusion criteria were human studies (open-label, double-blind, randomized, and placebo-controlled trials) and reviews of the use of botulinum toxin type A in trigeminal neuralgia treatment, published in English, Spanish or Portuguese from January 2008 to March 2020. Twenty-one articles met the inclusion criteria. Overall, studies demonstrated that botulinum toxin type A significantly reduced pain intensity and paroxysmal episodes, as well as improved quality of life.

CONCLUSION: Use of botulinum toxin type A in treatment of refractory trigeminal neuralgia shows promising results, but further studies are needed to increase the knowledge and consolidation of this therapeutic alternative.

Keywords

Botulinum toxins, Facial pain, Trigeminal neuralgia

Resumo

JUSTIFICATIVA E OBJETIVOS: A neurotoxina botulínica do tipo A tem se mostrado interessante como opção terapêutica complementar ao tratamento convencional da neuralgia trigeminal, sobretudo em pacientes sem resposta satisfatória à farmacoterapia e/ou procedimentos cirúrgicos. Uma revisão da literatura detalhada e abrangente se faz importante para descrever as evidências disponíveis e permitir uma visão crítica sobre o tema. Sendo assim, este estudo teve como objetivo apresentar as evidências científicas disponíveis na literatura sobre o uso da neurotoxina botulínica do tipo A no tratamento da neuralgia trigeminal.

CONTEÚDO: Foi realizada uma busca nas bases de dados Pubmed e Scielo utilizando-se os seguintes descritores "trigeminal neuralgia and botulinum toxin". Os critérios de inclusão foram estudos em humanos (estudos abertos e ensaios clínicos duplamente encobertos, randomizados e controlados por placebo) e revisões sobre o uso da neurotoxina botulínica do tipo A no tratamento da neuralgia trigeminal nos idiomas inglês, espanhol ou português durante o período de janeiro de 2008 a março de 2020. Apenas 21 artigos preencheram os critérios de inclusão. De um modo geral, os trabalhos demonstraram efeitos significativos da neurotoxina botulínica do tipo A na diminuição da intensidade da dor e no número de episódios paroxísticos, assim como na melhoria da qualidade de vida.

CONCLUSÃO: O uso da neurotoxina botulínica do tipo A no tratamento da neuralgia trigeminal refratária apresenta resultados promissores, mas são necessários novos estudos para ampliação do conhecimento e consolidação dessa alternativa terapêutica.

Palavras-chave

Dor facial, Neuralgia do trigêmeo, Toxinas botulínicas

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Submitted date:
03/30/2020

Accepted date:
05/10/2020

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