%0 Journal Article
%T Role of Botulinum Toxin Type-A (BTX-A) in the Management of Trigeminal Neuralgia
%A Gaurav Verma
%J Pain Research and Treatment
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/831094
%X Trigeminal neuralgia (TN) is a clinical condition characterized by paroxysmal attacks of severe and electric shock-like pain along the distribution of one or more branches of the trigeminal nerve. Various medicinal or surgical modalities have been employed in the past with variable success. Newer methods were tried in search of permanent cure or long-lasting pain relief. The purpose of this paper is to present the review of the literature regarding the use of botulinum toxin type-A (BTX-A) in the management of trigeminal neuralgia. 1. Introduction The English philosopher John Locke in 1677 firstly described the trigeminal neuralgia (TN). In 1756, Nicolaus Andre coined the term ¡°tic douloureux¡± for the condition characterized by trigeminal neuralgia pain as well as muscle spasm. In 1773, John Fothergill gave detailed description of the trigeminal neuralgia [1]. Trigeminal neuralgia (TN) is a painful disorder of the trigeminal nerve characterized by paroxysmal attacks of severe, electric shock-like pain typically present on one side of the face. Pain is unilateral and follows one or more of the distributions of the trigeminal nerve. Mandibular and maxillary divisions are more commonly involved than ophthalmic division. There is a slight predilection for female sex. The right side of the face is more commonly involved than the left side of the face. Trigeminal neuralgia affects approximately 1 person in 25,000 people. It is more prevalent in middle or old age group people [1¨C3]. Various treatment modalities for trigeminal neuralgia include medicinal management, peripheral nerve injection of local anesthetic or alcohol, peripheral neurectomies, alcohol injection of trigeminal ganglion, and intracranial neurosurgical procedures [4]. 2. Botulinum Toxin (BTX) The botulinum toxin (BTX) is a naturally occurring neurotoxin that is produced by gram-positive anaerobic bacteria Clostridium botulinum. There are seven distinct antigenic subtypes of botulinum toxin. Botulinum toxin type-A (BTX-A) is the most commonly used form for cosmetic purposes [5]. The BTX-A is prepared by Hall strain Clostridium botulinum fermentation. It is precipitated, filtered, and further processed into a vacuum-dried fine powder. A standard vial of BTX-A contains 100 units of toxin, 0.5£¿mg of human albumin, and 0.9£¿mg of sodium chloride [6]. 3. Risks Factors and Adverse Effects of Botulinum Toxin (BTX) Botulinum toxin has a high safety profile, reflected by paucity of documented irreversible medical complications [7, 8]. Botulinum toxin is most effective at local injection site. Minute
%U http://www.hindawi.com/journals/prt/2013/831094/