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Botulinum toxin a improved burning pain and allodynia in two patients with spinal cord pathology
Bahman Jabbari1, Neil Maher, Marc P Difazio
1Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA. bjabbari@mxa.usuh.mil
Objective:
To report the effect of botulinum toxin A in two patients with burning pain and allodynia of spinal cord origin.
Design, Setting, Patients:
Two patients with spinal cord lesions at the cervical level (tumor and stroke) experienced exquisite skin sensitivity and spontaneous burning pain in dermatomes corresponding to the cord lesions. Botulinum toxin A (Botox) was injected subcutaneously at multiple points (16 to 20 sites, 5 units/site) in the area of burning pain and allodynia.
Results:
Both patients reported significant improvement in spontaneous burning pain and allodynia in visual analogue scale and clinical measures. The analgesic effect of botulinum toxin A lasted at least 3 months and was sustained over follow-up periods of 2 and 3 years with repeated administration at 4-month intervals.
Conclusion:
Subcutaneous application of botulinum toxin A relieved central burning pain and allodynia in two patients with spinal cord pathology.
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