Subcutaneous Botulinum Toxin Type-A Injections for the Treatment of Central Neuropathic Pain in a Patient With Multiple Sclerosis - A Case Report.

Abstract

BACKGROUND: Neuropathic pain is a common, but difficult-to-treat, condition affecting the quality of life of many. It is prevalent in patients with multiple sclerosis (MS), an autoimmune chronic inflammatory disease of the central nervous system. Treatments, such as gabapentin, pregabalin, tricyclic antidepressants, serotonin, and norepinephrine reuptake inhibitors, are insufficient. As a result, botulinum neurotoxin type A (BoNT-A) has been explored for its effects on pain control with neuropathic pain. CASE REPORT: We present a 59-year-old woman with chronic neuropathic pain and MS. She presented to us with allodynia in the lateral portion of her left trunk, radiating into her breast to the nipple. The patient reported improvement in pain after subcutaneous injections of BoNT-A over the area of pain. CONCLUSIONS: In the present case report, we highlight the effectiveness of subcutaneous BoNT-A for the treatment of refractory central neuropathic pain in MS.