Botulinum Toxin Type-A (Botulax®) Treatment in Patients with Intractable Chronic Occipital Neuralgia: A Pilot Study

Abstract

Intractable chronic occipital neuralgia (ON) is an uncommon type of headache often experienced by patients in outpatient neurological clinics. Among patients unresponsive to oral neuralgia medications, needling or injections with several drugs were suggested alternatives for treating chronic ON. This study aimed to determine the effectiveness and safety of botulinum toxin type-A (BTX-A) injection treatments, where eight patients with unilateral chronic ON received BTX-A injections at the pain sites. The pain relief effect was observed 2 weeks after receiving the injections, gradually showing improvements up to 12 weeks after injection. There were no adverse events or changes from baseline in serologic studies and vital signs in any of the participants. The treatment’s pain-relieving effects were confirmed through regular, 12-week follow-ups, confirming the safety and effectiveness of BTX-A on chronic ON and suggesting that this method is an effective, novel alternative option for chronic ON treatment.

Effects of acupuncture in the treatment of occipital neuralgia: A systematic review and meta-analysis

“…A total of 823 unique studies were identified, of which 19 studies (between 2005 and 2021) fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. [11,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Fifteen studies included 916 subjects with neuralgia at the start of the study; 462 of them were using acupuncture and 454 were given other medication as control. Four studies discussed the safety parameter for acupuncture compared with control including 159 for acupuncture group and 158 for control group.…”

“…In addition, most of these studies were carried out in Asian countries and not widely applied in other cultures which may bias the findings of the current studies by reporting a lower degree of pain following acupuncture (placebo effect). Acupuncture plus medication had a significantly higher effective rate of treatment compared to medication in the treatment of occipital neuralgia.. [11,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Four studies used for analysis for acupuncture safety, the acupuncture group showed a significantly (P = .003) lower number of adverse events compared with control group (medication) which reflect the suitability of acupuncture compared with tradition medications.…”