Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up
We sought to assess the efficacy of combining onabotulinumtoxinA (BoNTA) as add-on therapy to carbamazepine or oxcarbazepine in treatment-refractory patients with trigeminal neuralgia (TGN) who failed to respond (less than 30% response rate) to adequate monotherapy. We conducted a retrospective stud...
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MDPI AG
2023-08-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/15/9/539 |
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| author | Georgia Xiromerisiou Ioannis C. Lampropoulos Emmanouil V. Dermitzakis Michail Vikelis Chrysoula Marogianni Dimitrios Mysiris Andreas A. Argyriou |
| author_facet | Georgia Xiromerisiou Ioannis C. Lampropoulos Emmanouil V. Dermitzakis Michail Vikelis Chrysoula Marogianni Dimitrios Mysiris Andreas A. Argyriou |
| author_sort | Georgia Xiromerisiou |
| collection | DOAJ |
| description | We sought to assess the efficacy of combining onabotulinumtoxinA (BoNTA) as add-on therapy to carbamazepine or oxcarbazepine in treatment-refractory patients with trigeminal neuralgia (TGN) who failed to respond (less than 30% response rate) to adequate monotherapy. We conducted a retrospective study on 15 patients with a definite diagnosis of TGN, according to the established criteria, and underwent BoNTA as part of their treatment plan. A single BoNTA session was administered subcutaneously, according to patients’ perceived zone of pain, at different dosages ranging from 30 to 200 units (mean ± standard deviation: 87.3 ± 39.2). All patients (15/15; 100%) reported large reductions in the severity of their TGN-related neuropathic pain. The mean pain score on the VAS scale significantly decreased from 9.3 ± 1.1 to 3.7 ± 1.2 at 2 weeks after injecting BoNTA (<i>p</i> < 0.001) and remained stable at 4 and 24 weeks post-injection. Regarding the impact of BoNTA on patients’ health-related quality of life, there were significant improvements in both the physical and mental health domains (<i>p</i> < 0.05) of SF-36 tool. BoNTA may be a safe and effective treatment option for patients with refractory TGN when added on to carbamazepine or oxcarbazepine. The use of a single BoNTA session for TGN treatment may be an alternative to surgical interventions and as add-on treatment to oral medications, providing patients with a minimally invasive, effective, safe and well-tolerated option. |
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| language | English |
| last_indexed | 2024-03-10T21:53:44Z |
| publishDate | 2023-08-01 |
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| series | Toxins |
| spelling | doaj.art-8456b17fbd7547b8a49e5cfc7bbc4db82023-11-19T13:15:45ZengMDPI AGToxins2072-66512023-08-0115953910.3390/toxins15090539Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow UpGeorgia Xiromerisiou0Ioannis C. Lampropoulos1Emmanouil V. Dermitzakis2Michail Vikelis3Chrysoula Marogianni4Dimitrios Mysiris5Andreas A. Argyriou6Department of Neurology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, 41110 Larissa, GreeceRespiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41110 Larissa, GreeceEuromedica General Clinic, 54645 Thessaloniki, GreeceHeadache Clinic, Mediterraneo Hospital, 16675 Glyfada, GreeceFaculty of Medicine, School of Health Sciences, University Hospital of Larissa, 41110 Larissa, GreeceFaculty of Medicine, School of Health Sciences, University Hospital of Larissa, 41110 Larissa, GreeceHeadache Outpatient Clinic, Department of Neurology, Agios Andreas State General Hospital of Patras, 26335 Patras, GreeceWe sought to assess the efficacy of combining onabotulinumtoxinA (BoNTA) as add-on therapy to carbamazepine or oxcarbazepine in treatment-refractory patients with trigeminal neuralgia (TGN) who failed to respond (less than 30% response rate) to adequate monotherapy. We conducted a retrospective study on 15 patients with a definite diagnosis of TGN, according to the established criteria, and underwent BoNTA as part of their treatment plan. A single BoNTA session was administered subcutaneously, according to patients’ perceived zone of pain, at different dosages ranging from 30 to 200 units (mean ± standard deviation: 87.3 ± 39.2). All patients (15/15; 100%) reported large reductions in the severity of their TGN-related neuropathic pain. The mean pain score on the VAS scale significantly decreased from 9.3 ± 1.1 to 3.7 ± 1.2 at 2 weeks after injecting BoNTA (<i>p</i> < 0.001) and remained stable at 4 and 24 weeks post-injection. Regarding the impact of BoNTA on patients’ health-related quality of life, there were significant improvements in both the physical and mental health domains (<i>p</i> < 0.05) of SF-36 tool. BoNTA may be a safe and effective treatment option for patients with refractory TGN when added on to carbamazepine or oxcarbazepine. The use of a single BoNTA session for TGN treatment may be an alternative to surgical interventions and as add-on treatment to oral medications, providing patients with a minimally invasive, effective, safe and well-tolerated option.https://www.mdpi.com/2072-6651/15/9/539neuropathic paintreatment-refractory trigeminal neuralgiaonabotulinumtoxinAsymptomatic therapy |
| spellingShingle | Georgia Xiromerisiou Ioannis C. Lampropoulos Emmanouil V. Dermitzakis Michail Vikelis Chrysoula Marogianni Dimitrios Mysiris Andreas A. Argyriou Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up Toxins neuropathic pain treatment-refractory trigeminal neuralgia onabotulinumtoxinA symptomatic therapy |
| title | Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up |
| title_full | Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up |
| title_fullStr | Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up |
| title_full_unstemmed | Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up |
| title_short | Single OnabotulinumtoxinA Session Add-On to Carbamazepine or Oxcarbazepine in Treatment-Refractory Trigeminal Neuralgia: A Case Series with 24-Week Follow Up |
| title_sort | single onabotulinumtoxina session add on to carbamazepine or oxcarbazepine in treatment refractory trigeminal neuralgia a case series with 24 week follow up |
| topic | neuropathic pain treatment-refractory trigeminal neuralgia onabotulinumtoxinA symptomatic therapy |
| url | https://www.mdpi.com/2072-6651/15/9/539 |
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