Is Botulinum Toxin A of Any Use for Managing Neuropathic Pain?

The use of botulinum toxin as a potentially effective treatment for neuropathic pain has grown. The antinociceptive effect of botulinum toxin suggests that it inhibits the release of peripheral neurotransmitters and inflammatory mediators from sensory nerves. To examine the effect of repeated doses of botulinum toxin A on neuropathic pain, researchers conducted a double-blind, placebo-controlled trial at two outpatient clinics in France and one in Brazil. Patients aged 18 to 85 years with peripheral neuropathic pain were randomized to receive two subcutaneous administrations of up to 300 units of botulinum toxin or placebo, 12 weeks apart. All patients and investigators were masked to treatment assignment. The primary outcome was change in …