Article

Botulinum neurotoxin (BoNT) is usually used in physiatric practice in the
treatment of spasticity and dystonia. Research involving both animal and human
subjects has emerged suggesting potential benefits in painful neuropathic
conditions. The animal data strongly support the use of BoNT in the treatment of
sensitized pain states. BoNT is probably effective at treating postherpetic
neuralgia, probably or possibly effective at treating postoperative/posttraumatic
neuropathic pain, and probably effective at treating painful diabetic neuropathy.
BoNT's proposed mechanism of action is described as decreasing sensitized
nociception in four ways by (1) inhibiting glutamate release in peripheral
tissues, (2) decreasing calcitonin gene-related peptide release in peripheral
tissue, (3) decreasing transient receptor potential cation channel subfamily V
member 1 trafficking to peripheral neuron cell membrane, and (4) decreasing
substance P release in peripheral tissue.
This review discusses pertinent
cellular / animal basic science research in conjunction with clinical research with
regard to the role of BoNT in treating neuropathic pain.

Langue : ANGLAIS