• Lunde Hanne Marie Bøe HM Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway. , Øivind Torkildsen, Lars Bø, and Anne Kjørsvik Bertelsen.
• Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
• Headache. 2016 Jun 1; 56 (6): 1035-9.

BackgroundTrigeminal neuralgia (TN) is one of the most agonizing facial pain disorders that humans endure. Studies on onabotulinum toxin A (BTX-A) treatment for TN are limited, but promising with respect to TN of no identifiable cause. We aimed to investigate the efficiency and safety of BTX-A treatment in a 60-year-old male with diabetes mellitus who in March 2013 presented with TN caused by an exostosis in Meckel's cave.MethodsThe patient was medically treatment refractory due to insufficient pain relief and adverse events of hyperglycemia, and surgery was declined due to complex anatomy. As a last resort, BTX-A was injected into the pain trigger zones of the trigeminal nerve (V5).ResultsComplete analgesia was reported 2 weeks after BTX-A injection. Pain medications were discontinued and laboratory values returned to acceptable levels. Regular BTX-A treatment during the next 28 months showed sustained analgesic effect.ConclusionsBTX-A has an excellent safety profile and may be efficient for patients with symptomatic TN not suited for conventional therapies.© 2016 American Headache Society.

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