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Onabotulinum toxin a treatment for posttraumatic trigeminal neuropathic pain: case series and literature review

  • Huann Lan Tan1,2
  • Pankaew Yakkaphan1,3
  • Amandine Beke1
  • Tara Renton1,*,

1Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, SE5 8AF London, UK

2Faculty of Dentistry, The National University of Malaysia, 50300 Kuala Lumpur, Malaysia

3Faculty of Dentistry, Prince of Songkla University, 90112 Songkhla, Thailand

DOI: 10.22514/jofph.2024.009 Vol.38,Issue 1,March 2024 pp.93-105

Submitted: 28 February 2022 Accepted: 29 August 2022

Published: 12 March 2024

*Corresponding Author(s): Tara Renton E-mail:


This case series aimed to assess the treatment outcomes of onabotulinum toxin A (BTX-A) in patients with refractory posttraumatic trigeminal neuropathic pain (PTNP) and to conduct a narrative review of the evidence for BTX-A in PTNP. Thirteen patients were treated with BTX-A infiltrations. Patient demographic and pain characteristics, BTX-A administration, and treatment outcomes were retrospectively analyzed. Papers retrieved after a literature search of articles on PTNP treatment using BTX-A were reviewed. Six patients reported an improvement in pain 3 months after the initial BTX-A injection, with 4 patients reporting a 50% reduction. Two patients achieved an 80% reduction in pain score over 3 years of BTX-A therapy. Three patients reported temporary ipsilateral facial muscle weakness. The literature review revealed five case reports on the use of BTX-A in PTNP patients that reported similar effectiveness to the present cohort study. BTX-A may be a potential treatment modality for refractory PTNP, thus reducing the need for polypharmacy. Multiple intraoral BTX-A injections administered over the painful sites are well tolerated, safe and easily practiced. High-quality studies are required to evaluate the long-term therapeutic efficacy and side effects of BTX-A therapy.


Botulinum toxin; Neuropathic pain; Submucosal; Traumatic trigeminal neuropathy; Trigeminal neuropathy

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Huann Lan Tan,Pankaew Yakkaphan,Amandine Beke,Tara Renton. Onabotulinum toxin a treatment for posttraumatic trigeminal neuropathic pain: case series and literature review. Journal of Oral & Facial Pain and Headache. 2024. 38(1);93-105.


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