Botulinum toxin type A treatment for Trigeminal Neuralgia

Case Report of a patient unresponsive to pharmacotherapy.

Abstract

Trigeminal Neuralgia (TN) is a chronic neuropathic disorder characterized by episodic, sharp facial pain, often unresponsi-ve to standard pharmacologic treatments. This case report pre-sents a 51-year-old female with classical TN affecting the right maxillary branch (V2), who experienced inadequate relief from conventional anticonvulsants and declined surgical interven-tion. Botulinum toxin type A (BTX-A) was administered intra-dermally at the sites of pain, following a protocol based on pri-or literature. Two weeks post-treatment, the patient reported a significant reduction in pain intensity—from a Visual Analog Scale (VAS) score of 9/10 to 3/10—and decreased frequency of attacks. Symptom relief persisted for approximately 4.5 months with no observed adverse effects. This report highlights BTX-A as a promising alternative therapy for refractory TN, especially in patients unsuitable for invasive procedures. Further stu-dies are warranted to evaluate long-term efficacy and safety.