Emerging treatments
OnabotulinumtoxinA
OnabotulinumtoxinA, 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 onabotulinumtoxinA 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 postherpetic 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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