Sandrini Giorgio, De Icco Roberto, Tassorelli Cristina, Smania Nicola, Tamburin Stefano
C. Mondino National Institute of Neurology Foundation, IRCCS, Pavia, Italy.
Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
J Headache Pain. 2017 Dec;18(1):38. doi: 10.1186/s10194-017-0744-z. Epub 2017 Mar 21.
Despite their huge epidemiological impact, primary headaches, trigeminal neuralgia and other chronic pain conditions still receive suboptimal medical approach, even in developed countries. The limited efficacy of current pain-killers and prophylactic treatments stands among the main reasons for this phenomenon. Botulinum neurotoxin (BoNT) represents a well-established and licensed treatment for chronic migraine, but also an emerging treatment for other types of primary headache, trigeminal neuralgia, neuropathic pain, and an increasing number of pain conditions.
We searched and critically reviewed evidence for the efficacy of BoNT for the treatment of chronic pain.
Meta-analyses and randomized controlled trials (RCTs) suggest that BoNT potentially represents a multi-purpose drug for the treatment of pain in several disorders due to a favorable safety profile and a long-lasting relief after a single injection.
BoNT is an emerging treatment in different pain conditions. Future RCTs should explore the use of BoNT injection therapy combined with systemic drugs and/or physical therapies as new pain treatment strategies.
尽管原发性头痛、三叉神经痛和其他慢性疼痛状况具有巨大的流行病学影响，但即使在发达国家，其医学治疗方法仍未达到最佳效果。当前止痛药和预防性治疗效果有限是造成这一现象的主要原因之一。肉毒杆菌神经毒素（BoNT）是一种已被充分确立且获得许可的慢性偏头痛治疗方法，也是一种用于其他类型原发性头痛、三叉神经痛、神经性疼痛以及越来越多疼痛状况的新兴治疗方法。
我们检索并批判性地回顾了肉毒杆菌神经毒素治疗慢性疼痛疗效的证据。
荟萃分析和随机对照试验表明，由于肉毒杆菌神经毒素安全性良好且单次注射后能产生持久缓解效果，它可能是治疗多种疾病疼痛的多功能药物。
肉毒杆菌神经毒素是不同疼痛状况下的一种新兴治疗方法。未来的随机对照试验应探索将肉毒杆菌神经毒素注射疗法与全身性药物和/或物理疗法相结合作为新的疼痛治疗策略。
