Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain

Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especial...

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Main Authors: Young Eun Moon, Jung Hyun Choi, Hue Jung Park, Ji Hye Park, Ji Hyun Kim
Format: Article
Language:English
Published: MDPI AG 2016-01-01
Series:Toxins
Subjects:
Online Access:http://www.mdpi.com/2072-6651/8/1/18
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author Young Eun Moon
Jung Hyun Choi
Hue Jung Park
Ji Hye Park
Ji Hyun Kim
author_facet Young Eun Moon
Jung Hyun Choi
Hue Jung Park
Ji Hye Park
Ji Hyun Kim
author_sort Young Eun Moon
collection DOAJ
description Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA) into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.
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spelling doaj.art-4ab234db9d494fa0a92c737677e47ff12022-12-22T04:22:11ZengMDPI AGToxins2072-66512016-01-01811810.3390/toxins8010018toxins8010018Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic PainYoung Eun Moon0Jung Hyun Choi1Hue Jung Park2Ji Hye Park3Ji Hyun Kim4Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222 Banpo-Daero, Seoul 137-701, KoreaDepartment of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222 Banpo-Daero, Seoul 137-701, KoreaDepartment of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222 Banpo-Daero, Seoul 137-701, KoreaDepartment of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222 Banpo-Daero, Seoul 137-701, KoreaDepartment of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, 222 Banpo-Daero, Seoul 137-701, KoreaNeuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA) into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.http://www.mdpi.com/2072-6651/8/1/18botulinum toxin type Adiabetic polyneuropathynerve blockpostherpetic neuralgia
spellingShingle Young Eun Moon
Jung Hyun Choi
Hue Jung Park
Ji Hye Park
Ji Hyun Kim
Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
Toxins
botulinum toxin type A
diabetic polyneuropathy
nerve block
postherpetic neuralgia
title Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
title_full Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
title_fullStr Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
title_full_unstemmed Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
title_short Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain
title_sort ultrasound guided nerve block with botulinum toxin type a for intractable neuropathic pain
topic botulinum toxin type A
diabetic polyneuropathy
nerve block
postherpetic neuralgia
url http://www.mdpi.com/2072-6651/8/1/18
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