Uso da toxina botulínica na neuralgia trigeminal: revisão de literatura

Abstract

Trigeminal neuralgia is considered a chronic craniofacial neuropathic pain limited to the area innervated by one or more branches of the trigeminal nerve, considered one of the strongest types of pain a person can experience, considerably limiting primordial facial functions. The use of botulinum toxin has been effective in the treatment of several painful conditions, including trigeminal neuralgia, in these cases botulinum toxin type A is a safe therapeutic option, with low risk of complications and with good results.The present study aims to review the literature seeking evidence and advances in the use of botulinum toxin in the treatment of trigeminal neuralgia, discussing its mechanism of action, and the results in the treatment of this neuropathic pain. A search for articles was carried out using the following search engines: PubMed, Google Scholar, Scielo and relevant books on the subject, covering national and international literature, free original articles and available in full. Considering the limitations and objectives of this work, it can be concluded, based on the literature, that botulinum toxin type A injections are effective as a treatment for trigeminal neuralgia due to its antinociceptive mechanism; however, it should be reserved for patients who are refractory to conventional pharmacological treatment. In these patients, the use of low doses is recommended, which, according to the reviewed literature, correspond to 25 U. More clinical studies with an adequate methodology are needed, mainly comparing BTX-A with pharmacological therapies with an adequate follow-up time to know their true effectiveness.