Emerging treatments
Botulinum toxin type A
Botulinum toxin type A, a neurotoxin produced by Clostridium botulinum that acts to prevent acetylcholine release from nerves, has been used in a variety of conditions including cervical dystonias, temporomandibular joint pain syndromes, and chronic migraine. One meta-analysis of 672 patients reported that botulinum toxin type A was associated with a significant improvement of trigeminal neuralgia symptoms, compared with placebo.[26]
Lidocaine
Intravenous lidocaine has been used for various neuropathic pain syndromes (e.g., diabetic neuropathy, HIV and post-herpetic neuralgias, as well as neuropathies associated with cancer, stroke, spinal cord injury, and amputation). One meta-analysis of 672 patients reported that lidocaine was associated with a significant improvement of trigeminal neuralgia symptoms, compared with placebo.[26] There is very little evidence that topical forms of lidocaine are effective in the treatment of neuropathic pain; further studies are required.[34]
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