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Botulinum Toxin Treatment of Chronic Facial Pain: Trigeminal Neuralgia and Temporo-Mandibular Disorders

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Botulinum Toxin Treatment of Pain Disorders

Abstract

Chronic facial pain is physically and emotionally disabling. Trigeminal neuralgia, pain associated with temporomandibular disorders are some of the most common forms of chronic facial pain. Despite the advances in pharmacological and surgical treatment of these disorders, many patients with these ailments remain unsatisfied with the level of pain relief. This chapter begins with a review of clinical features, pathophysiology, and conventional treatment of these two forms of chronic facial pain. The literature in efficacy of botulinum neurotoxins (BoNTs) in trigeminal neuralgia and pain related to temporomandibular disorders is reviewed. Selected case reports from the author’s experience are provided. A comment paragraph, at the end of each section, critically reviews the technical and dosage issues and provides recommendations for the design of future studies. Currently, a significant level of efficacy for local use of botulinum toxins can be ascribed only for trigeminal neuralgia (one class I study, level B, probably effective). In temporomandibular disorder, data from retrospective and prospective studies (including one double-blind, class II investigation) strongly suggests efficacy and safety, and successful techniques have been described by experienced clinicians. There is a need for large, double-blind, multicenter clinical trials in this area.

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Authors and Affiliations

  1. Professor Emeritus of Neurology, Yale University School of Medicine, New Haven, CT, USA

    Bahman Jabbari MD, FANN

  2. Clinical Professor of Neurology, University of California, Irvine, CA, USA

    Bahman Jabbari MD, FANN

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Jabbari, B. (2022). Botulinum Toxin Treatment of Chronic Facial Pain: Trigeminal Neuralgia and Temporo-Mandibular Disorders. In: Botulinum Toxin Treatment of Pain Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-99650-5_10

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