[Botulinum toxin and painful XXXX : what should be expected?].

@entity1 @entity1931 @entity6 @entity16 @entity1897 @entity158 @entity21115 @entity14000 @entity9 @entity130 @entity934
Botulinum toxin type A (BTX-A) is a potent neurotoxin that blocks @entity934 release from presynaptic nerve terminals by cleaving the SNARE complex. BTX-A has been reported to have analgesic effects independent of its action on muscle tone. The most robust results have been observed in @entity1 with @entity9 . @entity9 due to @entity1897 has been the most widely studied. BTX-A has shown its efficacy on @entity158 and @entity1931 in various animal models of inflammatory @entity9 . The only randomized, double-blind, placebo-controlled trial in @entity1 with focal @entity21115 due to nerve @entity130 or @entity14000 demonstrated significant effects on average @entity158 intensity from 2 weeks after the injections to 14 weeks. Most @entity1 reported @entity158 during the injections, but there were no further local or systemic side effects. The efficacy of BTX-A in painful @entity1897 has been more recently studied. Results were positive in the only study in an animal model of @entity1897 . One study in @entity1 with @entity6 painful @entity1897 demonstrated a significant decrease in Visual Analog Scale. In conclusion, one session of multiple intradermal injection of BTX-A produces long-lasting analgesic effects in @entity1 with focal @entity21115 and @entity6 @entity9 , and is particularly well tolerated. The findings are consistent with a @entity1897 , the place of a possible central effect remaining to define. Further studies are needed to assess some important issues, i.e. BTX-A efficacy in @entity1 with small fiber @entity16 and the relevance of early and repeated injections. Future studies could also provide valuable insights into pathophysiology of @entity9 .
