A new treatment paradigm for trigeminal neuralgia using Botulinum toxin type A

Elizabeth Guardiani, Babak Sadoughi, Andrew Blitzer, David Sirois

Research output: Contribution to journalReview articlepeer-review


Objectives To review the current data for the use of Botulinum toxin type A (BoNT-A) in trigeminal neuralgia (TN) and to describe the preferred injection technique of BoNT-A in TN. To propose a new treatment paradigm for TN incorporating the use BoNT-A. Data Sources MEDLINE and Google Scholar databases. Review Methods The current data on BoNT-A for TN were reviewed and analyzed for outcomes. Results Seven studies examining the use of BoNT-A were identified: Two randomized double-blind, placebo-controlled studies and five prospective case series. All studies found BoNT-A to be an effective treatment in the majority of patients; and the results of the two randomized double-blind placebo-controlled study showed significant benefit over placebo. The majority of studies used an intradermal or subcutaneous injection technique. The most common side effect was transient facial paresis. Conclusions BoNT-A offers a safe, effective, local treatment for TN that is nonablative in nature. BoNT-A should be considered in patients who have failed, become refractory to, or are unable to tolerate first-line pharmacologic treatments. Level of Evidence N/A.

Original languageEnglish (US)
Pages (from-to)413-417
Number of pages5
Issue number2
StatePublished - Feb 2014


  • Botulinum toxin
  • Facial pain
  • trigeminal neuralgia

ASJC Scopus subject areas

  • Otorhinolaryngology


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