Intraneural Injection of Botulinum Toxin-A in Palliative Care and Unresponsive Neuropathic Pain

María del Pilar Ascensio Mercado ； Marilina Susana Olea ； Ana Teles Rodrigues ； Karla Espinoza Morales ； Juan Jose Llavador Ros ； Ece Yamak Altinpulluk ； Carlos H. Salazar-Zamorano ； Felice Galluccio ； Mario Fajardo-Pérez

《Asia Pacific Journal of Pain》 預刊文章 Pp. 1-6

https://doi.org/10.29760/APJP.202302/PP.0001

摘要

Neuropathic pain has different causes including surgery, trauma, viral infections, cancer, vascular malformations, alcoholism, neurological conditions such as multiple sclerosis, and metabolic conditions such as diabetes. Although there are various medical treatments for chronic neuropathic pain, these treatments may have limited or weak evidence, as well as interventional treatments, which have short-term efficacy and therefore require repeated interventions over time. Botulinum toxin type-A (BT-A) has been used for its analgesic effects in different pain situations. There are several potential mechanisms of action of BT-A, which are currently being researched. We report a series of three cases where ultrasound-guided intraneural infiltration with BT-A was administered as compassionate use for successful treatment of persistent neuropathic pain. This method may be effective for patients with persistent neuropathic pain and provide long-lasting effects. More studies, including randomized and controlled trials, are required to confirm the effectiveness of the treatment. Until more evidence arrives, intraneural injection of BT-A can be considered when conventional treatment has failed.

關鍵字

botulinum toxin-A ； neuropathic pain ； palliative care