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Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect
BACKGROUND: Some studies have indicated that a local injection of Botulinum Toxin Type A (BTX-A) is a promising therapy for trigeminal neuralgia (TN). However, BTX-A treatment is still ineffective for approximately 10–43% of patients. We therefore investigated which factors are associated with the t...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643497/ https://www.ncbi.nlm.nih.gov/pubmed/31410051 http://dx.doi.org/10.2147/JPR.S205467 |
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author | Wu, Shouyi Lian, Yajun Zhang, Haifeng Chen, Yuan Wu, Chuanjie Li, Shuang Zheng, Yake Wang, Yuhan Cheng, Wenchao Huang, Zhi |
author_facet | Wu, Shouyi Lian, Yajun Zhang, Haifeng Chen, Yuan Wu, Chuanjie Li, Shuang Zheng, Yake Wang, Yuhan Cheng, Wenchao Huang, Zhi |
author_sort | Wu, Shouyi |
collection | PubMed |
description | BACKGROUND: Some studies have indicated that a local injection of Botulinum Toxin Type A (BTX-A) is a promising therapy for trigeminal neuralgia (TN). However, BTX-A treatment is still ineffective for approximately 10–43% of patients. We therefore investigated which factors are associated with the therapeutic effect in BTX-A treatment of medically refractory, classical TN. METHODS: We performed a retrospective cohort study with a total of 104 patients who were receiving BTX-A injection for medically refractory classical TN between August 2013 and October 2016. A VAS score, pain attack frequency per day as well as patients’ overall response to treatment and side effects were evaluated in 104 patients with TN who were receiving BTX-A. RESULTS: A total of 87 patients reported successful results; 41 stated that their pain was completely controlled while 46 reported adequate pain relief, totaling 83.7%. Our study suggests that treatment success was higher in patients 50 or older (OR=3.66, 95% CI: 1.231–10.885). Univariate and multivariate analyses demonstrated that the patient’s age was independently associated with treatment outcome (OR=1.72, 95% CI: 1.063–2.282), with ≥50 years being a significant predictor of pain relief (P=0.020 and P=0.033, respectively). Seventeen patients (16.3%) reported mild side effects. CONCLUSION: A local injection of BTX-A may be a safe and efficient treatment for classical TN which lasts for several months. BTX-A is a novel strategy which is particularly worth trying for particularly middle-aged and elderly patients who cannot tolerate drug side effects and may be afraid of serious complications from microvascular decompression. |
format | Online Article Text |
id | pubmed-6643497 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-66434972019-08-13 Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect Wu, Shouyi Lian, Yajun Zhang, Haifeng Chen, Yuan Wu, Chuanjie Li, Shuang Zheng, Yake Wang, Yuhan Cheng, Wenchao Huang, Zhi J Pain Res Original Research BACKGROUND: Some studies have indicated that a local injection of Botulinum Toxin Type A (BTX-A) is a promising therapy for trigeminal neuralgia (TN). However, BTX-A treatment is still ineffective for approximately 10–43% of patients. We therefore investigated which factors are associated with the therapeutic effect in BTX-A treatment of medically refractory, classical TN. METHODS: We performed a retrospective cohort study with a total of 104 patients who were receiving BTX-A injection for medically refractory classical TN between August 2013 and October 2016. A VAS score, pain attack frequency per day as well as patients’ overall response to treatment and side effects were evaluated in 104 patients with TN who were receiving BTX-A. RESULTS: A total of 87 patients reported successful results; 41 stated that their pain was completely controlled while 46 reported adequate pain relief, totaling 83.7%. Our study suggests that treatment success was higher in patients 50 or older (OR=3.66, 95% CI: 1.231–10.885). Univariate and multivariate analyses demonstrated that the patient’s age was independently associated with treatment outcome (OR=1.72, 95% CI: 1.063–2.282), with ≥50 years being a significant predictor of pain relief (P=0.020 and P=0.033, respectively). Seventeen patients (16.3%) reported mild side effects. CONCLUSION: A local injection of BTX-A may be a safe and efficient treatment for classical TN which lasts for several months. BTX-A is a novel strategy which is particularly worth trying for particularly middle-aged and elderly patients who cannot tolerate drug side effects and may be afraid of serious complications from microvascular decompression. Dove 2019-07-17 /pmc/articles/PMC6643497/ /pubmed/31410051 http://dx.doi.org/10.2147/JPR.S205467 Text en © 2019 Wu et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Wu, Shouyi Lian, Yajun Zhang, Haifeng Chen, Yuan Wu, Chuanjie Li, Shuang Zheng, Yake Wang, Yuhan Cheng, Wenchao Huang, Zhi Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title | Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title_full | Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title_fullStr | Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title_full_unstemmed | Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title_short | Botulinum Toxin Type A for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
title_sort | botulinum toxin type a for refractory trigeminal neuralgia in older patients: a better therapeutic effect |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643497/ https://www.ncbi.nlm.nih.gov/pubmed/31410051 http://dx.doi.org/10.2147/JPR.S205467 |
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