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Botulinum Toxin Treatment of Chronic Facial Pain: Trigeminal Neuralgia, Temporomandibular Disorders, and Dental-Related Pain

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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, and dental-related pain are some of the most common forms of chronic facial pain. Despite the advances in pharmacological therapy 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 three forms of chronic facial pain. The literature in the efficacy of botulinum neurotoxins (BoNTs) in trigeminal neuralgia, pain related to temporomandibular disorders, and dental disorders is reviewed. Case reports from the author’s experience are provided in selected patients. A comment page, 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 pain, data generated from retrospective studies and observation of experienced clinicians suggesting efficacy are encouraging, but solid blinded and controlled studies are lacking and very much needed. In chronic neuropathic pain following dental procedures, the positive data on the local use of BoNTs is limited to few anecdotal observations.

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Authors and Affiliations

  1. Botulinum Toxin Treatment Program, Yale School of Medicine, New Haven, CT, USA

    Bahman Jabbari (Professor of Neurology and Director)

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  1. Bahman Jabbari
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Jabbari, B. (2015). Botulinum Toxin Treatment of Chronic Facial Pain: Trigeminal Neuralgia, Temporomandibular Disorders, and Dental-Related Pain. In: Botulinum Toxin Treatment of Pain Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2501-8_10

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  • DOI: https://doi.org/10.1007/978-1-4939-2501-8_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2500-1

  • Online ISBN: 978-1-4939-2501-8

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