Has anyone heard of Botox injections helping TN pain
I have type II Neuropathic pain. Thus far Botox has been the only thing to help me. Is my pain gone? No, but it has become less frequent and I am able to come off all meds- I have had no side effects, I do notice when it is wearing off. So, it has not fixed my problem..I have had 5 injections in the last 18 months.. I also get trigger point injections, in my face, inside my mouth, neck and shoulders in the interim- every three weeks. My insurance will not cover this, but It has been a god sent, and would spend any amount of money to have my life back- this is the closest I have come. Thanks to my Dr and Botox
Would you please give me the name and phone number of your doctor? I would like to speak with him about that type of treatment. My dermatologist doesn’t have a clue about this treatment.
I am a little confused as to why you would see a dermatologist for facial pain.... I know that is who would generally give botox, but it has been known to help facial pain. Many Pain Management Dr's have now started to use botox. have you tried that avenue yet?
I have had it many times. I have a recurrence of TN II pain that occurred about 9 months after a successful repeat MVD. I originally had the botox by a plastic surgeon to reduce forehead wrinkles before my son's wedding and discovered it lessened my TN pain. I've had it quite a few times since and it has helped decrease my eye pain. This last time however, it really did not help :(
There is also an article about it in the Journal of the Royal Society of Medicine (J R Soc Med Sh Rep 2013;4:10) titled "An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions.
No I haven’t! I’ve seen a neurologist. He was the one that diagnosed my condition. I’ve been taking 1800 mgs. of Gabapentin In combination with 100 mgs. of tegrotol. Someone mentioned Botox to me and I just assumed a dermatologist would be the one to contact. This is all pretty new to me…
Hi,
I have TN 2 thanks to an endodontist hitting my nerve about 8 years ago. What has helped significantly decrease the pain is having Botox treatments every 3 months. I have also developed pain now on the other side and that includes stabbing ear pain at times. The Botox has proved very successful for me. It has enabled me to go down to one medication. However, I do get flare ups with the weather. However, I can deal with those because on a daily basis I am doing so much better. Also, the pain will get worse as the Botox is wearing off.
Thanks!
Yes. My doctor used Botox therapy for the migraines I now have daily as a result of TN. I know it works for many but not for me. I actually developed a horrible ringing in my ears as a result that has never gone away. I know he wanted to also use Botox for a shot inside the mouth. He said he is having very good response from his patients with the shot inside the mouth. I opted out as he is just trying too much at once and I would never know what is working. Perhaps it does work. I know that Botox tapes up to 10 days to kick-in fully and the effects can last for 3-6 months or more. I just can't risk the possibility of something going wrong and being stuck with the side effects for months. I would not count it out in the future. If you have confidence in your doctor then you should strongly consider it for yourself.
I am thinking about doing Botox, but at the same time I am terrified that it might get worse. I cant handle any worse... I live in Houston, do anybody maybe can recommend someone around here?
I have had it mult. times for spasms around eye and cheek, and it has helped, although after years of doing this, I have one eye closed more than the other, or "smaller" looking. I've also had injections around the ear, behind the head/neck for GN several times and that has been a big waste of money. I also as another writer wrote, had Botox between my eyes and on less occasion in other facial areas that have big wrinkles from constantly wincing in pain and found it helpful in decreasing pain also. I guess it's just like when you have a bad attack you try to hold your face still until the pain subsides, only this does it before the pain.
Yikes! Sounds scary! I can just imagine having one side of the mouth drooping and drooling. But heck, I don't know.
richard_scott said:
Yes. My doctor used Botox therapy for the migraines I now have daily as a result of TN. I know it works for many but not for me. I actually developed a horrible ringing in my ears as a result that has never gone away. I know he wanted to also use Botox for a shot inside the mouth. He said he is having very good response from his patients with the shot inside the mouth. I opted out as he is just trying too much at once and I would never know what is working. Perhaps it does work. I know that Botox tapes up to 10 days to kick-in fully and the effects can last for 3-6 months or more. I just can't risk the possibility of something going wrong and being stuck with the side effects for months. I would not count it out in the future. If you have confidence in your doctor then you should strongly consider it for yourself.
I’ve had 2 rounds of Botox, one in December & just recently March 10th.
( every 3 months) My Oral Pain Specialist administers it.
Like anything else research as much as you can to make an informative decision, I also asked my neurologist & Gp to share their opinions.
Only side effect I’ve notice is my upper eyelids were slightly swollen the first I had it done. No one else noticed unless I pointed it out.
I will tell you it’s very important to have the Botox administered by someone who has had training with Botox for Pain. It is given differently than for those who do it for cosmetic reasons. Depth of needle as well as location on your face in regards to your pain areas as well as quantity is different.
My doctor takes at least 25 photos of my face from different angles, different expressions, to monitor any changes from the Botox. She gives me dental freezing prior to administering it on my painful left side. It has to be done on both sides of your face ( I’m bilateral ) to maintain symmetry .
Botox takes approximately 2 weeks to notice any changes, and some say the more often ( meaning, every 3 months for a year or so) it’s done the more positive results on your pain in regards to pain of TN and Migraines. There aren’t enough studies on Botox for TN, it’s mainly all Botox for migraines.
The premise with Botox is this;
The botox is injected into the muscles closest to your pain areas on your face, the nerve endings pick it up, it then blocks the nerve from firing it’s neuro transmitter, which normally makes the muscle contract.
I can’t really comment on whether or not it’s working for me, as I’ve been trying a few different things at once. I’ll have a better idea after my 3 injections in June.
I do know that the facial ( dental) freezing I get positively breaks my intense pain cycles. I’m currently researching this more…
Below is some info I’ve collected , hope it helps…
(( hugs )) Mimi xx
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<a rel="nofollow" href="http://www.oralhealthgroup.com/news/review-of-the-applications-of-botulinum-toxin-and-tissue-fillers-in-dental-practice/1003098988/?&er=NA" target="_blank">http://www.oralhealthgroup.com/news/review-of-the-applications-of-b...</a><br/>
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PS all images can be seen if you go the link above...
Botulinum Toxin-A (BTX-A) is one of eight sub-types of a neurotoxin produced by the bacterium Clostridium botulinum.1 It behaves primarily as a blocking agent at the nerve level by temporarily preventing the release neurotransmitters such as acetylcholine (Fig. 1). In this way it can relax skeletal muscle as well as inhibit glandular secretions.2,3 In muscle, it lowers maximum contractile force as well as resting tone. Reversal of the toxin’s effect occurs through several mechanisms and takes from one to four months.4,5 There is no damage to either the nerves or the target tissues.<br/>
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FIGURE 1.<br/>
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Are Botulinum Toxins Safe?<br/>
In Canada only the ‘A’ type toxin is available and sold as Botox® (Allergan) and Xeomin® (Merz). These products are slightly different in their formulation and therefore behave slightly differently in some clinical applications (Fig. 2). Dosing regimens are similar but not interchangeable between these two products.6 Botulinum toxins, despite their ominous name, are extremely safe drugs. Their therapeutic margin (LD50/ED50) is in the order of 15:1 meaning that systemic toxicity does not occur until doses reach 15 times the effective therapeutic dose.7 Lidocaine by comparison has TM of 3:1.8 Most unwanted effects result from the drug drifting to adjacent sites.9 This can result in unwanted muscle weakness such as an asymmetrical smile or a dry mouth. Only rarely does the drug cause significant dysfunction such as an inability to swallow, which is why a clinician must have a thorough understanding of regional anatomy as well as injection protocols. Side effects just like desired therapeutic effects are temporary and typically require no supportive intervention. Local injection sequelae are the same as with any other percutaneous injection and include bruising, erythema, and the possibility of infection.<br/>
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FIGURE 2. Botulinum type-A products share the same ‘core molecule’ but differ in the surrounding ‘accessory proteins’. It is the accessory proteins which alter the clinical behavior of products such as tissue diffusion. The illustration below is of Botox® which has 750 kD (kilo Daltons) of accessory proteins.<br/>
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Botulinum toxins for pain TN<br/>
Other forms of pain such as trigeminal neuralgia, post herpetic neuralgia, atypical dental pain and scar pain may also respond to toxins. The mechanism is believed to be related to inhibition of neurotransmitters in peripheral sensory nerves.17 Since these forms of pain often involve central as well as peripheral components, they are not nearly as responsive to BTX-A injections as muscular conditions are.23,24 The injections themselves are also different in that they target intra-dermal or intra-mucosal sensory nerve fibres rather than muscles. Injections are very superficial (intradermal or submucosal) and follow a grid-like pattern (Fig. 8).<br/>
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FIGURE 8. Neuropathic pain, such as Post Herpetic Neuralgia or Trigeminal Neuralgia, is often responsive to Botulinum Toxin injections. The injections are intra-dermal or subcutaneous and follow a grid pattern covering the painful dermatome. Above is an illustration of injections for PHN.<br/>
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It is critical that injectors have a thorough understanding of the anatomy of the muscles of facial expression and cosmetic injection protocols even if they are not injecting for cosmetic reasons. Intradermal and sub-dermal injections in the V1, V2 and V3 dermatomes will diffuse into the muscles potentially creating significant functional or cosmetic deficits (Fig. 9).<br/>
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FIGURE 9. Five days after left forehead (V1 dermatome) injections. Note eyelid ptosis, brow ptosis, forehead asymmetry and bruising. Injections for pain anywhere in the oro-facial complex should follow cosmetic protocols as much as possible to avoid needless complications.Hi Sharon,
I've had very good success with Botox injections. I'm also on 900 mg Gabapentin daily. The Botox injections are administered by my Neurologist. It makes the TN much more manageable. For me, I feel as though the pain has been "muffled." I still have flares and most definitely I have troubles towards the end of the quarter when I'm due for the shots. I can tell they're making a difference. I started the shots in 2014. There are 5 different types of Botox (there could be more). The type of Botox to treat TN and Migraines is different from cosmetic Botox. My insurance covers most of the cost of the medication, I only pay $50. But if they wouldn't cover it, I'd pay the $500 per quarter just for the relief. It's definitely worth it.
I have great success with Botox for migraines. I have been getting 15-20 injections every 10 weeks for the last 3 years. I truly believe that the Botox treatments have saved my life. I starting getting them at the worst of my depression due to the new TN and migraines in my life. I have never felt pain relief for the TN. (ATN2) Gosh, that would be fantastic if it helped with it all!
I have been having botox injections for chronic migraine for the last 2 years. It has been very helpful for that (reduced from 22 migraines/month to about 11-15/month. I have not noticed anything different with regard to the TN2 that I have on the left side of my face. I do know that I have had a long flare up (in the midst of that now), and the headaches and face pain trigger each other at this point. My neurologist administers the injections per FDA protocol for migraine. She has added eyes and jaws. TN pain has worsened over this year. Now, I’m adding type 1 into the mix. Maybe she can change the protocol a bit for the TN.
Hi Sharon, yes I have had 2 treatments of Botox and I find it wonderful. I suffer with facial spasms also and it relieved this immediately. The pain did deplete but it took a while. All the best Helen x
I’m glad you are having success. I’m in another quasi-remission, not much pain, but everpresent buzzing and numbness. Hard to tell which is working for what, and I will take whatever pain relief I can get!