New horizons in the treatment of post-herpetic neuralgia: the use of botulinum toxin type A

Vasconcelos RCFD, Andrade AGBF, Marostica L and Buffalo HC

Published on: 2023-07-15

Abstract

PHN is a syndrome defined by chronic neuropathic pain that persists for more than 3 months after the resolution of a Herpes Zoster (HZ) episode and is usually refractory to treatment. BTX-A has shown efficacy in pain treatment and has demonstrated improvement in the patient's quality of life, especially in cases refractory to previous therapies. This research is a retrospective observational study in which information was obtained from the medical records of 7 patients diagnosed with PHN who underwent treatment with incoBoNT/A (Xeomin®). Were applied the Visual/Numeric pain Scale (VNS) to analyze the patient's pain score before the initiation of treatment and at 2, 6, 12, and 16 weeks, and the Hospital Anxiety and Depression (HAD) scale, evaluated before treatment and 8 weeks after.  The VNS initially demonstrated that 71.4% of patients reported intense pain, while 28.6% reported moderate pain. After 12 weeks, 85.7% of patients no longer had pain, and at 16 weeks, 100% of patients were pain-free. About the HAD scale, initially 71.4% showed possible anxiety and 14.3% showed possible depression. After 8 weeks, all patients showed unlikely levels of anxiety and depression. In this context, numerous studies support our findings regarding the use of BTX-A in the treatment of postherpetic neuralgia, both in terms of pain reduction and improvement in the patient's quality of life. It proves to be a potent, effective, and safe therapeutic option. We conclude that  incoBoNT/A (Xeomin®) proves to be effective in the treatment of this disease. Large-scale studies and long-term follow-up are warranted to further confirm the analgesic effects of incoBoNT/A for patients suffering from the pain of NPH.