• Elizabeth Guardiani, Babak Sadoughi, Andrew Blitzer, and David Sirois.
• New York Center for Voice and Swallowing Disorders, St. Luke's-Roosevelt Hospital, New York, New York, U.S.A.
• Laryngoscope. 2014 Feb 1;124(2):413-7.

ObjectivesTo review the current data for the use of Botulinum toxin type A (BoNT-A) in trigeminal neuralgia (TN) and to describe the preferred injection technique of BoNT-A in TN. To propose a new treatment paradigm for TN incorporating the use BoNT-A.Data SourcesMEDLINE and Google Scholar databases.Review MethodsThe current data on BoNT-A for TN were reviewed and analyzed for outcomes.ResultsSeven studies examining the use of BoNT-A were identified: Two randomized double-blind, placebo-controlled studies and five prospective case series. All studies found BoNT-A to be an effective treatment in the majority of patients; and the results of the two randomized double-blind placebo-controlled study showed significant benefit over placebo. The majority of studies used an intradermal or subcutaneous injection technique. The most common side effect was transient facial paresis.ConclusionsBoNT-A offers a safe, effective, local treatment for TN that is nonablative in nature. BoNT-A should be considered in patients who have failed, become refractory to, or are unable to tolerate first-line pharmacologic treatments.Level Of EvidenceN/A.© 2013 The American Laryngological, Rhinological and Otological Society, Inc.

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