Tags

Type your tag names separated by a space and hit enter

Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study.
Headache 2008 Nov-Dec; 48(10):1476-81H

Abstract

OBJECTIVE

To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia.

BACKGROUND

Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain.

METHODS

Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values.

RESULTS

The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated.

CONCLUSIONS

Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain.

Authors+Show Affiliations

OrthoNeuro-Neurology, New Albany, OH, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

19076646

Citation

Taylor, Martin, et al. "Botulinum Toxin type-A (BOTOX) in the Treatment of Occipital Neuralgia: a Pilot Study." Headache, vol. 48, no. 10, 2008, pp. 1476-81.
Taylor M, Silva S, Cottrell C. Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study. Headache. 2008;48(10):1476-81.
Taylor, M., Silva, S., & Cottrell, C. (2008). Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study. Headache, 48(10), pp. 1476-81. doi:10.1111/j.1526-4610.2008.01089.x.
Taylor M, Silva S, Cottrell C. Botulinum Toxin type-A (BOTOX) in the Treatment of Occipital Neuralgia: a Pilot Study. Headache. 2008;48(10):1476-81. PubMed PMID: 19076646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study. AU - Taylor,Martin, AU - Silva,Sachin, AU - Cottrell,Constance, PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/2/28/medline SP - 1476 EP - 81 JF - Headache JO - Headache VL - 48 IS - 10 N2 - OBJECTIVE: To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. BACKGROUND: Occipital neuralgia is a unilateral or bilateral radiating pain with paresthesias commonly manifesting as paroxysmal episodes and involving the occipital and parietal regions. Common causes of occipital neuralgia include irritation or injury to the divisions of the occipital nerve, myofascial spasm, and focal entrapment of the occipital nerve. Treatment options include medication therapy, occipital nerve blocks, and surgical techniques. BTX-A, which has shown promise in relief of other headache types, may prove a viable therapeutic option for occipital neuralgia pain. METHODS: Botulinum toxin type-A (reconstituted in 3 cc of saline) was injected into regions traversed by the greater and lesser occipital nerve in 6 subjects diagnosed with occipital neuralgia. Subjects were instructed to report their daily pain level (on a visual analog pain scale), their ability to perform daily activities (on several quality of life instruments) and their daily pain medication usage (based on a self-reported log), 2 weeks prior to the injection therapy and 12 weeks following injection therapy. Data were analyzed for significant variation from baseline values. RESULTS: The dull/aching and pin/needles types of pain reported by the subjects did not show a statistically significant improvement during the trial period. The sharp/shooting type of pain, however, showed improvement during most of the trial period except weeks 3-4 and 5-6. The quality of life measures exhibited some improvement. The headache-specific quality of life measure showed significant improvement by 6 weeks which continued through week 12. The general health- and depression-related measures showed no statistical improvement. No significant reduction in pain medication usage was demonstrated. CONCLUSIONS: Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/19076646/Botulinum_toxin_type_A__BOTOX__in_the_treatment_of_occipital_neuralgia:_a_pilot_study_ L2 - https://doi.org/10.1111/j.1526-4610.2008.01089.x DB - PRIME DP - Unbound Medicine ER -