Patil Shilpadevi, Willett Olga, Thompkins Terin, Hermann Robert, Ramanathan Sathish, Cornett Elyse M, Fox Charles J, Kaye Alan David
Department of Anesthesiology, Louisiana State University Health Science Center, 1542 Tulane Ave, New Orleans, LA, 70112, USA.
Curr Pain Headache Rep. 2016 Mar;20(3):15. doi: 10.1007/s11916-016-0545-0.
Botulinum toxin, also known as Botox, is produced by Clostridium botulinum, a gram-positive anaerobic bacterium, and botulinum toxin injections are among the most commonly practiced cosmetic procedures in the USA. Although botulinum toxin is typically associated with cosmetic procedures, it can be used to treat a variety of other conditions, including pain. Botulinum toxin blocks the release of acetylcholine from nerve endings to paralyze muscles and to decrease the pain response. Botulinum toxin has a long duration of action, lasting up to 5 months after initial treatment which makes it an excellent treatment for chronic pain patients. This manuscript will outline in detail why botulinum toxin is used as a successful treatment for pain in multiple conditions as well as outline the risks associated with using botulinum toxin in certain individuals. As of today, the only FDA-approved chronic condition that botulinum toxin can be used to treat is migraines and this is related to its ability to decrease muscle tension and increase muscle relaxation. Contraindications to botulinum toxin treatments are limited to a hypersensitivity to the toxin or an infection at the site of injection, and there are no known drug interactions with botulinum toxin. Botulinum toxin is an advantageous and effective alternative pain treatment and a therapy to consider for those that do not respond to opioid treatment. In summary, botulinum toxin is a relatively safe and effective treatment for individuals with certain pain conditions, including migraines. More research is warranted to elucidate chronic and long-term implications of botulinum toxin treatment as well as effects in pregnant, elderly, and adolescent patients.
肉毒杆菌毒素，也被称为保妥适，由革兰氏阳性厌氧菌肉毒梭菌产生，在美国，肉毒杆菌毒素注射是最常见的美容手术之一。尽管肉毒杆菌毒素通常与美容手术相关，但它可用于治疗多种其他病症，包括疼痛。肉毒杆菌毒素会阻止神经末梢释放乙酰胆碱，从而使肌肉麻痹并减轻疼痛反应。肉毒杆菌毒素作用时间长，初始治疗后可持续长达5个月，这使其成为慢性疼痛患者的理想治疗方法。本手稿将详细概述为何肉毒杆菌毒素能成功治疗多种病症中的疼痛，以及概述在某些个体中使用肉毒杆菌毒素的相关风险。截至目前，美国食品药品监督管理局（FDA）唯一批准肉毒杆菌毒素可用于治疗的慢性病症是偏头痛，这与其降低肌肉紧张度和增加肌肉松弛度的能力有关。肉毒杆菌毒素治疗的禁忌症仅限于对毒素过敏或注射部位感染，目前尚无已知的与肉毒杆菌毒素的药物相互作用。肉毒杆菌毒素是一种有利且有效的替代性疼痛治疗方法，对于那些对阿片类药物治疗无反应的患者是一种可考虑的疗法。总之，肉毒杆菌毒素对于患有某些疼痛病症（包括偏头痛）的个体是一种相对安全有效的治疗方法。需要更多研究来阐明肉毒杆菌毒素治疗的慢性和长期影响以及对孕妇、老年人和青少年患者的影响。
