Do you find onabotulinumtoxinA injections effective for the treatment of trigeminal neuralgia?  

I use botulinum toxin (off-label) for two face pain conditions, one rare, i.e., trigeminal neuralgia, and one common, i.e., temporomandibular disorder (TMD). For trigeminal neuralgia, I use a tiny needle to inject very small amounts of the toxin into the affected area of the skin and, if involved in...

For TMJ disorders (TMJD), I administer low-dose Botox injections into both the temporalis and masseter muscles, targeting 2-3 sites per muscle dose depending on the severity of symptoms and muscle size. For trigeminal neuralgia, I use a superficial injection technique, applying Botox in a grid-like ...

I have never used it. From a quick literature review, there is limited evidence for efficacy. There have been case reports/series, and small prospective observational studies. There is a recent meta-analysis by Hu et al., PMID 38385501, where they reported four RCTs and several observational studies...

I use onabotulinumtoxinA in patients with trigeminal neuralgia who have not responded to first line treatments. Usually I will have tried carbamazepine or oxcarbazepine, lamotrigine, and gabapentin/pregabalin at least before trying. I particularly try if surgical treatment is not an option. I have s...

I've had a very similar experience with Dr. @Spierings, treated several at least dozens, perhaps (>)> 100 patients with trigeminal nerve pain in my former clinics at Duke. There were approximately ½ of those who suffered neuralgic attacks, most with underlying continuous pain, and very ...

Botox is not covered by insurance for trigeminal neuralgia in the US, nor is TMJ, so their use is limited in general. I use spinal cord stimulation (SCS) for trigeminal neuralgia, and it has been a life changing procedure for most of my trigeminal neuralgia patients, after years of failed attempts ...