The Therapeutic Effect of Botulinum Toxin Type A on Trigeminal Neuralgia: Are There Any Differences between Type 1 versus Type 2 Trigeminal Neuralgia?

Yan Tereshko; Mariarosaria Valente; Enrico Belgrado; Chiara Dalla Torre; Simone Dal Bello; Giovanni Merlino; Gian Luigi Gigli; Christian Lettieri

doi:10.3390/toxins15110654

The Therapeutic Effect of Botulinum Toxin Type A on Trigeminal Neuralgia: Are There Any Differences between Type 1 versus Type 2 Trigeminal Neuralgia?

Toxins (Basel). 2023 Nov 14;15(11):654. doi: 10.3390/toxins15110654.

Authors

Yan Tereshko^{1

2}, Mariarosaria Valente^{1

2}, Enrico Belgrado³, Chiara Dalla Torre³, Simone Dal Bello¹, Giovanni Merlino^{1

2}, Gian Luigi Gigli², Christian Lettieri^{1

2}

Affiliations

¹ Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.
² Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy.
³ Neurology Unit, Udine University Hospital, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.

Abstract

Background: Botulinum toxin type A is an effective treatment for trigeminal neuralgia. Moreover, its efficacy in type 2 trigeminal neuralgia and comparative studies between type 1 and type 2 trigeminal neuralgia (TN) still need to be improved.

Methods: We treated 40 TN patients with onabotulinumtoxinA; 18 had type 1 TN, and 22 had type 2 TN. We compared the baseline pain score with the Visual Analogue Scale (VAS) and paroxysm frequency (number per week) at the baseline with those obtained at 1-month and 3-month follow-ups. Nonetheless, we compared the baseline Penn Facial Pain Scale with the scores obtained at the 1-month follow-up.

Results: BoNT/A effectively reduced pain intensity and frequency at the 1-month and 3-month follow-ups. Moreover, the type 1 TN and type 2 TN groups had baseline pain scores of 7.8 ± 1.65 and 8.4 ± 1.1, respectively. Pain significantly improved (p < 0.001) in both groups to 3.1 ± 2.3 (type 1 TN) and 3.5 ± 2.3 (type 2 TN) at the 1-month follow-up and to 3.2 ± 2.5 (type 1 TN) and 3.6 ± 2.5 (type 2 TN) at the 3-month follow-up. There was no difference between the two groups (p 0.345). The baseline paroxysm frequencies (number per week) were 86.7 ± 69.3 and 88.9 ± 62.2 for the type 1 and type 2 TN groups, respectively; they were significantly reduced in both groups at the 1-month and 3-month follow-ups without significant differences between the two groups (p 0.902). The Pain Facial Pain Scale improved at the 1-month follow-up, and no significant differences were found between the two groups. There was a strong correlation between background pain and paroxysm pain intensity (r 0.8, p < 0.001).

Conclusions: Botulinum toxin type A effectively reduced the pain, paroxysm frequency, and PFPS scores of type 1 and type 2 trigeminal neuralgia patients without statistically significant differences. Facial asymmetry was the only adverse event.

Keywords: atypical trigeminal neuralgia; botulinum toxin type A; neuropathic pain; trigeminal neuralgia; type 1 trigeminal neuralgia; type 2 trigeminal neuralgia.

MeSH terms

Botulinum Toxins, Type A* / toxicity
Facial Pain / drug therapy
Humans
Pain Measurement
Treatment Outcome
Trigeminal Neuralgia* / drug therapy

Substances

Botulinum Toxins, Type A

Grants and funding

This research received no external funding.