Botulinum Toxin A Injections Helpful For Some Patients With Peripheral Neuropathic Pain Interview with:
Nadine Attal, MD PhD
Professeur associée de l’UVSQ
CHU Ambroise Paré
92100 Boulogne-Billancourt What is the background for this study? What are the main findings?

Dr. Attal: The background for this study is based on the findings of experimental studies in animals and healthy subjects indicating that botulinum toxin type A  (BTX-A) may have analgesic activity independent of its effect on muscle tone.

BTX-A has been reported to have analgesic effects against peripheral neuropathic pain in prior trials, but the quality of the evidence was generally low, as it was derived mostly from small pilot studies and no study has evaluated the relevance of repeated administrations for the treatment of NP. Furthermore, the clinical profiles of the patients responding to BTX-A have not been fully characterized. What should clinicians and patients take away from your report?

Dr. Attal: They should take away that two repeated subcutaneous administrations of botulinum toxin type A are effective in peripheral  neuropathic pain but mostly in patients with allodynia and/or limited thermal deficits. BTX-A also appears to be particularly effective on paroxysmal pain (ie electric shock like pain).

Finally, the efficacy of a second administration of BTX-A is enhanced over the first injection. What recommendations do you have for future research as a result of this study?

Dr. Attal: Future research should better take into account the patients phetotypic profiles for randomized controlled trials and should not necessarily classify patients as per etiology but rather based on their symptoms or symptom combinations, which suggest specific mechanisms. Is there anything else you would like to add?

Dr. Attal: BTX-A is an alternative medication for refractory patients with peripheral  neuropathic pain and limited area of pain, particularly those with allodynia and limited thermal deficits. The drug should only be administered by specialists. Thank you for your contribution to the community.


Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial

Attal, Nadine et al.
The Lancet Neurology , Volume 0 , Issue 0 ,
Published Online: 29 February 2016
[wysija_form id=”5″]

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on

Dr. Nadine Attal (2016). Botulinum Toxin A Injections Helpful For Some Patients With Peripheral Neuropathic Pain 

Last Updated on March 7, 2016 by Marie Benz MD FAAD