Botulinum toxin assessment, intervention and aftercare for paediatric and adult niche indications including pain: international consensus statement

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
B RawickiCerebral Palsy Institute

Abstract

Evidence is emerging for the use of botulinum neurotoxin type-A (BoNT-A) for niche indications including pain independent of spasticity. Pain indications such as chronic nociceptive back pain, piriformis syndrome, chronic myofascial pain, pelvic pain, complex regional pain syndrome, facial pain and neuropathic pain are outlined in this paper. Of these, class I evidence is available for the treatment of chronic nociceptive low back pain, piriformis syndrome, myofascial pain, facial pain, neuropathic pain and plantar fasciitis. Peri-operative use of BoNT-A is emerging, with indications including planning for surgery and facilitating surgery, as well as healing and improving analgesia post-operatively. Evidence is limited, although there are some reports that clinicians are successfully using BoNT-A peri-operatively. There is class I evidence showing pre-operative use of BoNT-A has a beneficial effect on outcomes following adductor-release surgery. The use of BoNT for treatment of tremor, other than neck tremor in the setting of cervical dystonia, including evidence for upper limb tremor, cranial tremor and non-dystonic neck tremor is reviewed. The evidence is variable at this stage, and further study is required to develop defini...Continue Reading

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Citations

Feb 13, 2013·Pharmacotherapy·Jack J Chen, Khashayar Dashtipour
Aug 22, 2013·Developmental Medicine and Child Neurology·Iona NovakShona Goldsmith
Feb 24, 2015·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Fariborz RahimiMandar Jog
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Jun 6, 2018·The Journal of Spinal Cord Medicine·Ramiro Palazón-GarcíaAna María Benavente-Valdepeñas
Nov 5, 2016·PM & R : the Journal of Injury, Function, and Rehabilitation·Michelangelo BuonocoreElena Dalla Toffola
Jun 3, 2021·International Journal of Molecular Sciences·Ramiro Palazón-García, Ana María Benavente-Valdepeñas
Jul 6, 2021·Anesthesiology and Pain Medicine·Neeraj VijIvan Urits

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