Case ReportInjections of Botulinum Toxin Type A Produce Pain Alleviation in Intractable Trigeminal NeuralgiaAllam, Nasser MD*; Brasil-Neto, Joaquim P. MD, PhD*; Brown, Gilberto MD†; Tomaz, Carlos PhD*Author Information From the *Graduate Program in Health Sciences and Department of Physiological Sciences, University of Brasília, Brasília, Brazil; and the †Hospital de Base do Distrito Federal, Neurology Unit, Brasília, Brazil. Received for publication December 7, 2002; revised July 7, 2003; accepted September 19, 2003. Reprints: Dr. Carlos Tomaz, Department of Physiological Sciences, Institute of Biology, University of Brasília, Brasília, DF, Brazil, CEP 70910-900 (e-mail: firstname.lastname@example.org). The Clinical Journal of Pain: March-April 2005 - Volume 21 - Issue 2 - p 182-184 Buy Abstract To report the effects of local injections of botulinum toxin type A regarding pain relief and long-term control in a patient with intractable trigeminal neuralgia. The patient was a 75-year-old man with trigeminal neuralgia in the left hemifacial region. His pain was unbearable and could not be controlled by carbamazepine, amitriptyline, or blocked by infiltration of a glycerol solution or phenol. The authors evaluated pain intensity, quality, and location using a Visual Analog Scale to establish the efficacy of botulinum toxin type A injections. Two units of botulinum toxin type A (Botox®) were subcutaneously injected once in eight points distributed along the territory of V1 and V2. Visual Analog Scores were measured at baseline and at 7, 30, 60, and 90 days after treatment. The authors also examined the patient's general condition and daily life activities. The Visual Analog values were, respectively, 82, 54, 25, 25, and 45 mm at each follow-up examination. No side effects were observed on the site of injection and on the patient's clinical state. The authors have been able to reduce trigeminal neuralgia pain with botulinum toxin type A injections in the V1, V2 territory during all the period of study, as well as to withdraw all medication. Interestingly, there was concomitant reduction of pain also in V3, which was not injected. © 2005 Lippincott Williams & Wilkins, Inc.