Evidencia y experiencia del uso de onabotulinumtoxinA en neuralgia del trigémino y cefaleas primarias distintas de la migraña crónica

Lasaosa, Sonia Santos; Cuadrado, María‐Luz; Gago-Veiga, Ana Beatriz; Ál, Guerrero-Peral; Irimia, P.; Laínez, José Miguel; Leira, Rogelio; Pascual, Julio; Porta‐Etessam, Jesús; Río, Margarita Sánchez del; Romero, J. Viguera; Pozo‐Rosich, Patricia

doi:10.1016/j.nrl.2017.09.003

Cited by 15 publications

(9 citation statements)

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“…It is a validated alternative for refractory trigeminal neuralgia. 6,7 Some case reports stated significantly reduced pain scores and disability after regional BoNT injections (mostly 50 U) for occipital neuralgia. [8][9][10] Concerning nummular headache, a recent study demonstrated that BoNT (25 U) reduced the frequency and intensity of the headache and the need for acute treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Besides, it seems to control the delivery of glutamate at a central level, as well as the modulation of the endogenous opioid system, thus reducing the pain perception. 7,[12][13][14] Although best studied for chronic migraine, these mechanisms may also explain BoNT effectiveness in other craniofacial pain conditions, including the auriculotemporal neuralgia. 7 To our knowledge, there are no previous reports of BoNT injections for auriculotemporal neuralgia.…”

Section: Discussionmentioning

confidence: 99%

“…7,[12][13][14] Although best studied for chronic migraine, these mechanisms may also explain BoNT effectiveness in other craniofacial pain conditions, including the auriculotemporal neuralgia. 7 To our knowledge, there are no previous reports of BoNT injections for auriculotemporal neuralgia. The "follow-the-pain" protocol, taking in consideration the temporal part of the PREEMPT protocol, allowed us to adjust the BoNT dose to the patient's needs.…”

Section: Discussionmentioning

confidence: 99%

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Botulinum toxin as a novel therapeutic approach for auriculotemporal neuralgia

2021

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A 44-year-old female patient was evaluated in the emergency department for persistent and refractory right temporoparietal headache lasting for 10 weeks. She had a medical history of migraine without aura, eosinophilic esophagitis, anxiety, and was allergic to nonsteroidal anti-inflammatory drugs (NSAIDs). The headache was continuous, of moderate to severe intensity (numeric pain scale 7/10), with occasional more intense paroxysms (9/10), and was partially relieved by sleep. She denied aura and dysautonomic signs. During this period, she had attended different neurologists and was prescribed topiramate 75 mg twice a day. She had been taking eletriptan 20 mg and a combination of analgesics (acetaminophen 400 mg + caffeine 100 mg + ergotamine 1 mg + belladonna alkaloids 0.1 mg) daily, but did not achieve pain relief. The patient was afebrile. The neurological examination, full blood tests, and non-contrast computed tomography (CT) were unremarkable. She was sequentially and unsuccessfully prescribed intravenous (iv) fluid therapy, acetaminophen 1 g iv, metoclopramide 10 mg iv, prednisolone 250 mg iv and sodium valproate 1 g iv, assuming a prolonged migraine status. She was admitted to a neurology ward. After careful review of the patient's complaints, we identified the right supra-auricular region as the most painful area. The pain was exacerbated by touch at the emergence of the auriculotemporal nerve. The patient was evaluated by a stomatologist, who ruled out temporomandibular joint pathology. Regional magnetic resonance imaging (MRI) excluded auriculotemporal nerve entrapment; brain MRI and magnetic resonance angiography (MRA) were also unremarkable. We presumed idiopathic auriculotemporal neuralgia as a plausible secondary diagnosis to migraine and performed an auriculotemporal nerve block with lidocaine 1% 1 cc. She achieved temporal pain relief but retained parietal dull pain, which we attributed to

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Botulinum toxin as a novel therapeutic approach for auriculotemporal neuralgia

2021

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“…OnabotA ha demostrado ser eficaz como tratamiento preventivo en pacientes con MC 12 , por lo que el Grupo de Estudio de Cefaleas de la Sociedad Española de Neurología (GECSEN) elaboró un documento de consenso estableciendo las recomendaciones para su uso en la práctica clínica en pacientes con MC 14 . En los últimos años su uso se está extendiendo a otras cefaleas primarias como las cefaleas trigémino-autonómicas y la neuralgia del trigémino, entre otras, elaborándose recientemente una revisión sobre su utilización en este tipo de cefaleas por parte del GECSEN 13 .…”

Section: Discussionunclassified

“…La inyección local de Onabotulinumto-xinA (OnabotA), o toxina botulínica tipo A, en el área dolorosa podría ser una alternativa, ya que ha demostrado ser efectiva en el tratamiento de diferentes dolores como la cefalea, el dolor articular y el dolor miofascial, habiéndose revelado también como un tratamiento útil en la neuropatía diabética dolorosa 10 y la neuralgia postherpética 11 . En el campo de las cefaleas, OnabotA tiene indicación bien establecida en la migraña crónica (MC) 12 , mientras que en los últimos años su uso se está extendiendo a otras cefaleas primarias (migraña episódica de alta frecuencia, cefaleas trigémino-autonómicas, cefalea numular) y a la neuralgia del trigémino 13 .…”

Section: Introductionunclassified