Botulinum neurotoxin type-A for primary stabbing headache: an open study

Piovesan, Élcio Juliato; Teive, H.; Kowacs, Pedro André; Silva, Lucas Leite da; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2010000200011

Cited by 15 publications

(9 citation statements)

References 10 publications

(18 reference statements)

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“…When the frequency of attacks is high, indomethacin is the medication of choice [1, 8, 13]. Other possibilities are melatonin, gabapentin and celecoxib and even the botulinum neurotoxin with different results [14]. …”

Section: Discussionmentioning

confidence: 99%

Incidence and influence on referral of primary stabbing headache in an outpatient headache clinic

et al. 2011

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Primary stabbing headache (PSH) is a pain, as brief, sharp, jabbing stabs, predominantly felt in the first division of trigeminal nerve. Population studies have shown that PSH is a common headache. However, most people suffer attacks of low frequency or intensity and seldom seek for medical assistance. There are few clinic-based studies of PSH, and its real influence as a primary cause for referral to neurology outpatient offices is to be determined. We aim to investigate the burden of PSH as main complaint in an outpatient headache clinic. We reviewed all patients with PSH (ICHD-II criteria), attended in an outpatient headache clinic in a tertiary hospital during a 2.5-year period (January 2008–June 2010). We considered demographic and nosological characteristics and if PSH was main cause of submission. 36 patients (26 females, 10 males) out of 725 (5%) were diagnosed of PSH. Mean age at onset 34.1 ± 2.9 years (range 10–72). Mean time from onset to diagnosis 68.8 ± 18.3 months. Twenty-four patients fulfilled ICHD-II criteria for other headaches (14 migraine, 6 tension-type headache, 2 hemicrania continua, 1 primary cough headache and 1 primary exertional headache). 77.7% of patients were submitted from primary care. In 14 patients (39%), PSH was main reason for submission, its intensity or frequency in 5 (35.7%) and fear of malignancy in 9 (74.3%). Only two patients of those who associated other headaches were submitted due to PSH. In conclusion, PSH is not an uncommon diagnosis in an outpatient headache office. However, and according to our data, it is not usually the main cause of submission to a headache clinic.

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Section: Discussionmentioning

confidence: 99%

Incidence and influence on referral of primary stabbing headache in an outpatient headache clinic

et al. 2011

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“…12 Botulinum toxin type A has also been shown to be an effective prophylactic in patients with chronic migraine and primary stabbing headaches. 13,14 However, some studies have shown no difference in pain after four weeks. 15,16 Thus, although BoNTA is known to effectively decrease spasticity, 3 it is not clear if BoNTA also simultaneously decreases pain as a result of reduction in spasticity.…”

mentioning

confidence: 99%

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Shaikh

Phadke

Ismail

et al. 2015

Can. J. Neurol. Sci.

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Objective: To assess the prevalence of pain in adults with spasticity and to assess the association between the subjective experience of pain and spasticity. Design: Cross-sectional study. Setting: outpatient spasticity management clinic of a rehabilitation centre. Patients: Patients with upper motor neuron lesions and spasticity (n = 131) were recruited. Methods: We assessed pain intensity and location, relationship between spasticity and pain perception, and perception of pain relief from botulinum toxin type-A (BoNTA) injections. Main outcome measures: Pain perception rated on a 10-point numerical rating scale and pain quality. Results: 65% of the patients with spasticity reported presence of pain and 60% described it as an aching pain. More patients reported pain with movement (34%) compared to rest (21%). There was a statistically poor correlation between the severity of pain and spasticity (r = 0.16; p > 0.05). Most patients (80%) believed that their pain was related to spasticity and 62% reported that BoNTA injections decreased their pain. Conclusions: The high incidence of pain noted within our sample suggests that physicians may have to consider pain management as part of spasticity treatment. Participants reported that their pain was related to their spasticity, and that it decreased after BoNTA treatment. Further study is needed to explore the relationships between objective measures of spasticity and pain.RÉSUMÉ: Relation entre la toxine botulique, la spasticité et la douleur : une enquête sur la perception des patients. Objectif: Le but de l'étude était de déterminer la prévalence de la douleur chez des adultes souffrant de spasticité et d'étudier l'association entre l'expérience subjective de la douleur et la spasticité. Devis de l'étude: Il s'agit d'une étude transversale. Contexte: Cette étude a été réalisée auprès de patients fréquentant une clinique dédiée au traitement de la spasticité dans un centre de réadaptation. Patients: Des patients atteints de lésions du neurone moteur supérieur et de spasticité ont été recrutés (n = 131). Méthode: Nous avons évalué l'intensité et la localisation de la douleur, la relation entre la spasticité et la perception de la douleur ainsi que la perception du soulagement de la douleur suite à des injections de toxine botulique de type A (BoNTA). Principaux critères d'évaluation: Les critères utilisés étaient la perception de la douleur évaluée sur une échelle numérique de 10 points et la qualité de la douleur. Résultats: Soixante-cinq pour cent des patients présentant de la spasticité ont rapporté la présence de douleur et 60% l'ont décrite comme une douleur sourde. Plus de patients ont rapporté de la douleur au mouvement (34%) qu'au repos (21%). La corrélation entre la sévérité de la douleur et la spasticité était faible au point de vue statistique (r = 0,16 ; p > 0,05). La plupart des patients (80%) croyaient que leur douleur était reliée à la spasticité et 62% rapportaient que les injections de BoNTA diminuaient la douleur. Conclusions: L'incidence ...

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“…In a double-blind, placebo-controlled study of chronic migraine patients, BoNT/A was effective in reducing the number, frequency, and intensity of migraine attacks 25 . We showed the analgesic effect of BoNT/A on primary stabbing headaches, a primary headache with ultra-short duration associated with migraine whose etiology is not fully understood and may be related to the sensitization of the trigeminal nerve 26 . In this study the patients were treated with intradermal injections of 12 units of BoNT/A.…”

Section: Clinical and Experimental Correlates In Humansmentioning

confidence: 99%

“…In this study the patients were treated with intradermal injections of 12 units of BoNT/A. Using the follow-the-pain approach; clinical improvement was observed by seven days and lasted up to 60 days 26 . In an open study of refractory trigeminal neuralgia, BoNT/A controlled the pain within a few days; the clinical response lasted approximately 60 days 11 .…”

Section: Clinical and Experimental Correlates In Humansmentioning

confidence: 99%

Botulinum neurotoxin type-A when utilized in animals with trigeminal sensitization induced a antinociceptive effect

Piovesan

Oshinsky

Silberstein

et al. 2016

Arq. Neuro-Psiquiatr.

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Purpose of the study was evaluate the possible antinociceptive effect of botulinum neurotoxin type-A (BoNT/A) in an experimental model of trigeminal neuralgia. Method Neuropathic pain was induced by surgical constriction of the infraorbital nerve in rats. A control group underwent a sham procedure consisting of surgical exposure of the nerve. Subgroups of each group received either BoNT/A or isotonic saline solution. The clinical response was assessed with the -20°C test. Animals that underwent nerve constriction developed sensitization; the sham group did not. Results The sensitization was reversed by BoNT/A treatment evident 24 hours following application. Pronociceptive effect was observed in the sham group following BoNT/A. Conclusion BoNT/A has an antinociceptive effect in sensitized animals and a pronociceptive effect in non-sensitized animals.

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Botulinum neurotoxin type-A for primary stabbing headache: an open study

Cited by 15 publications

References 10 publications

Incidence and influence on referral of primary stabbing headache in an outpatient headache clinic

Incidence and influence on referral of primary stabbing headache in an outpatient headache clinic

Relationship Between Botulinum Toxin, Spasticity, and Pain: a Survey of Patient Perception

Botulinum neurotoxin type-A when utilized in animals with trigeminal sensitization induced a antinociceptive effect

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