Clinical Neurology Unit, Udine University Hospital, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.
Department of Medicine (DAME), University of Udine, Via Colugna 50, 33100 Udine, Italy.
Toxins (Basel). 2023 Nov 14;15(11):654. doi: 10.3390/toxins15110654.
Botulinum toxin type A is an effective treatment for trigeminal neuralgia. Moreover, its efficacy in type 2 trigeminal neuralgia and comparative studies between type 1 and type 2 trigeminal neuralgia (TN) still need to be improved.
We treated 40 TN patients with onabotulinumtoxinA; 18 had type 1 TN, and 22 had type 2 TN. We compared the baseline pain score with the Visual Analogue Scale (VAS) and paroxysm frequency (number per week) at the baseline with those obtained at 1-month and 3-month follow-ups. Nonetheless, we compared the baseline Penn Facial Pain Scale with the scores obtained at the 1-month follow-up.
BoNT/A effectively reduced pain intensity and frequency at the 1-month and 3-month follow-ups. Moreover, the type 1 TN and type 2 TN groups had baseline pain scores of 7.8 ± 1.65 and 8.4 ± 1.1, respectively. Pain significantly improved ( < 0.001) in both groups to 3.1 ± 2.3 (type 1 TN) and 3.5 ± 2.3 (type 2 TN) at the 1-month follow-up and to 3.2 ± 2.5 (type 1 TN) and 3.6 ± 2.5 (type 2 TN) at the 3-month follow-up. There was no difference between the two groups ( 0.345). The baseline paroxysm frequencies (number per week) were 86.7 ± 69.3 and 88.9 ± 62.2 for the type 1 and type 2 TN groups, respectively; they were significantly reduced in both groups at the 1-month and 3-month follow-ups without significant differences between the two groups ( 0.902). The Pain Facial Pain Scale improved at the 1-month follow-up, and no significant differences were found between the two groups. There was a strong correlation between background pain and paroxysm pain intensity (r 0.8, < 0.001).
Botulinum toxin type A effectively reduced the pain, paroxysm frequency, and PFPS scores of type 1 and type 2 trigeminal neuralgia patients without statistically significant differences. Facial asymmetry was the only adverse event.
肉毒毒素 A 是治疗三叉神经痛的有效方法。此外，其在 2 型三叉神经痛中的疗效以及 1 型和 2 型三叉神经痛（TN）之间的比较研究仍有待改善。
我们用肉毒毒素 A 治疗了 40 例 TN 患者；其中 18 例为 1 型 TN，22 例为 2 型 TN。我们比较了基线疼痛评分（VAS）和基线时每周发作次数（发作次数/周）与 1 个月和 3 个月随访时的评分。此外，我们比较了基线时的 Penn 面部疼痛量表评分与 1 个月随访时的评分。
BoNT/A 能有效降低 1 个月和 3 个月随访时的疼痛强度和发作频率。此外，1 型 TN 和 2 型 TN 组的基线疼痛评分为 7.8±1.65 和 8.4±1.1，疼痛在两组中均显著改善（<0.001），1 个月随访时分别为 3.1±2.3（1 型 TN）和 3.5±2.3（2 型 TN），3 个月随访时分别为 3.2±2.5（1 型 TN）和 3.6±2.5（2 型 TN）。两组间无差异（0.345）。1 型 TN 和 2 型 TN 组的基线发作频率（发作次数/周）分别为 86.7±69.3 和 88.9±62.2，两组在 1 个月和 3 个月随访时均显著减少，两组间无差异（0.902）。1 个月随访时面部疼痛量表评分改善，两组间无差异。背景疼痛与发作时疼痛强度呈强相关性（r=0.8，<0.001）。
肉毒毒素 A 能有效降低 1 型和 2 型三叉神经痛患者的疼痛、发作频率和 PFPS 评分，无统计学差异。面部不对称是唯一的不良反应。
