Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.
Neurological Diseases Group, Post-Graduate Program in Internal Medicine, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil.
Acta Neurol Scand. 2022 Feb;145(2):193-199. doi: 10.1111/ane.13533. Epub 2021 Sep 20.
To determine the effectiveness of botulinum toxin in a sample of patients diagnosed with greater occipital nerve neuralgia.
Twenty-nine patients (28 females, 1 male) were treated for greater occipital nerve neuralgia with onabotulinum toxin type A; the Visual Analog Pain Scale was used to determine pain severity at treatment and again 12 weeks after application.
Average doses of onabotulinum toxin type A of 18.66±6.44 U per nerve and 35.96±12.89 U per patient were utilized. Average pain severity among the sample was 9.81±0.89 prior to botulinum toxin application and 3.68±2.31 points (p<0.0001) twelve weeks after application. Pain frequency decreased from 29.93±0.37 to 12.17±11.05 days with pain per month (p<0.0001). Six patients reported absence of pain after application (p=0.023). Dose did not correlate with the degree of clinical response observed, and no side effects were reported.
Our findings suggest onabotulinum toxin type A is a safe and effective treatment alternative for patients suffering from refractory greater occipital nerve neuralgia.
评估肉毒毒素 A 在诊断为枕大神经痛的患者样本中的疗效。
29 名患者（28 名女性，1 名男性）因枕大神经痛接受肉毒毒素 A 治疗；使用视觉模拟疼痛量表评估治疗时和应用后 12 周时的疼痛严重程度。
每根神经使用的肉毒毒素 A 平均剂量为 18.66±6.44U，每位患者的平均剂量为 35.96±12.89U。样本中平均疼痛严重程度在应用肉毒毒素 A 前为 9.81±0.89，应用后 12 周时为 3.68±2.31 分（p<0.0001）。疼痛频率从每月 29.93±0.37 天降至 12.17±11.05 天（p<0.0001）。应用后 6 名患者报告疼痛消失（p=0.023）。剂量与观察到的临床反应程度无关，且未报告任何副作用。
我们的研究结果表明，肉毒毒素 A 是治疗难治性枕大神经痛患者的一种安全有效的治疗选择。
