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...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2016-01-01
|
Series: | Toxins |
Subjects: | |
Online Access: | http://www.mdpi.com/2072-6651/8/1/18 |
_version_ | 1811184961516994560 |
---|---|
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. |
first_indexed | 2024-04-11T13:21:20Z |
format | Article |
id | doaj.art-4ab234db9d494fa0a92c737677e47ff1 |
institution | Directory Open Access Journal |
issn | 2072-6651 |
language | English |
last_indexed | 2024-04-11T13:21:20Z |
publishDate | 2016-01-01 |
publisher | MDPI AG |
record_format | Article |
series | Toxins |
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 |
work_keys_str_mv | AT youngeunmoon ultrasoundguidednerveblockwithbotulinumtoxintypeaforintractableneuropathicpain AT junghyunchoi ultrasoundguidednerveblockwithbotulinumtoxintypeaforintractableneuropathicpain AT huejungpark ultrasoundguidednerveblockwithbotulinumtoxintypeaforintractableneuropathicpain AT jihyepark ultrasoundguidednerveblockwithbotulinumtoxintypeaforintractableneuropathicpain AT jihyunkim ultrasoundguidednerveblockwithbotulinumtoxintypeaforintractableneuropathicpain |