There is a growing body of evidence suggesting that Botox is a safe and effective treatment for trigeminal neuralgia.
Trigeminal neuralgia (TN) is a chronic facial pain disorder characterized by sudden, severe, electric shock-like pain in one or more branches of the trigeminal nerve. This condition is relatively rare, with about 4.3 new cases per 100,000 people each year in the US.
TN can significantly impact quality of life, often leading to higher rates of depression, anxiety, and sleep disorders compared to the general population. Common triggers like brushing teeth, chewing, and swallowing can be so painful that individuals may neglect oral hygiene, lose weight, become dehydrated, and develop anxiety about these activities. TN can be highly disabling, with up to 45% of sufferers missing daily activities for at least 15 days in six months, and over 50% experiencing severe anxiety and depression related to their pain.
Trigeminal Neuralgia Treatment
The first line of treatment for TN usually includes anticonvulsant medications such as carbamazepine, oxcarbazepine, lamotrigine, gabapentin, lacosamide, or the muscle relaxant baclofen. However, these drugs often have side effects like fatigue, cognitive issues, dizziness, tremors, and electrolyte imbalances, which can limit their use. For acute pain flares, treatments like infusion therapy and trigeminal nerve blocks are used.
Surgical options for classic TN include microvascular decompression, gamma knife radiosurgery, and balloon compression, but these come with concerns about tolerability, long-term efficacy, and safety.
Botox for Trigeminal Neuralgia Treatment
Botox, also known as OnabotulinumtoxinA, FDA-approved for chronic migraine, is used off-label by neurologists for TN. Small studies have shown that it can be a safe and effective treatment, particularly for those who cannot tolerate medications or are not candidates for surgery. This treatment has been shown to reduce pain intensity and attack frequency and improve quality of life compared to a placebo.
Speak with your CNMRI neurologist about this treatment if you are having break through facial pain from TN in spite of multiple medication trials.
CNMRI: Neurology, Sleep Medicine, MRI 