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J Cutan Aesthet Surg 2022 Jan-Mar;15(1):95-96

Department of Dermatology, Mount Sinai Hospital, New York, USA.

Scalp dysesthesia is characterized by abnormal cutaneous sensations such as burning, stinging, or itching of the scalp. This condition is particularly challenging to manage as there is a lack of well-established treatments. By limiting release of neurotransmitters such as substance P, glutamate, and calcitonin gene-related peptide, botulinum toxin may have a role in ameliorating neuropathic pain. Read More

J Orthop Sci 2022 May 26. Epub 2022 May 26.

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Surgery/Orthopedic Section, King Abdulaziz Medical City, Jeddah, Saudi Arabia. Electronic address:

Background: Botulinum toxin type A (BTX-A) is the most popular therapeutic agent for muscle relaxation and pain control. Lately, BTX-A injection received great interest as a part of multimodal pain management for lower limb lengthening and deformity correction. This systematic review aimed to determine the role of BTX-A injection in pain management for during lower limb lengthening and/or deformity correction. Read More

Evid Based Dent 2022 May 27. Epub 2022 May 27.

Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK.

Objective An evidence-based review on the safety and efficacy of botulinum toxin type-A (BoNTA) in orofacial conditions, focusing on the therapeutic applications and role of BoNTA as an adjuvant treatment.Data source and selection Data was collected using PubMed (Medline), Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials electronic databases. Having satisfied the search parameters, 32 studies for therapeutic applications and 26 for BoNTA as an adjunctive treatment were included. Read More

Toxins (Basel) 2022 04 27;14(5). Epub 2022 Apr 27.

Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", 28100 Novara, Italy.

Although botulinum toxin (BoNT) has been suggested as a treatment to counter neuropathic pain, no previous systematic reviews investigated the multidimensional effects of BoNT on pain relief and Health-Related Quality of Life (HR-QoL). The aim of this systematic review is to summarize the current evidence on the effectiveness of BoNT treatment for neuropathic pain, and to characterize its multidimensional effectiveness in order to guide physicians in clinical practice. Five databases were systematically searched up to 4 April 2022, to identify randomized controlled trials satisfying the following criteria: adults suffering from neuropathic pain, BoNT administration, any comparator, multidimensional assessment of pain as primary outcome, HR-QoL, physical function, anxiety and depression, and sleep quality as secondary outcomes. Read More

Front Surg 2022 3;9:898850. Epub 2022 May 3.

Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy.

Background: External hemorrhoidal thrombosis (EHT) is a common complication of hemorrhoidal disease. This condition causes extreme pain, likely resulting from internal anal sphincter hypertonicity, which traps the hemorrhoids below the dentate line thus leading to congestion and swelling. The choice of treatment remains controversial and both conservative and surgical options have been proposed in the last decades. Read More

Am J Obstet Gynecol 2022 May 14. Epub 2022 May 14.

Division of Urogynecology and Reconstructive Pelvic Surgery, Warren Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island, Providence, RI.

Background: The efficacy of intradetrusor onabotulinumtoxinA injections for the management of idiopathic overactive bladder has been well-established. The injections are typically performed in the office setting using local analgesia, most commonly a 20 to 30-minute intravesical instillation of lidocaine. There are limited data evaluating alternative bladder analgesics. Read More

Nat Rev Dis Primers 2022 05 5;8(1):28. Epub 2022 May 5.

Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.

Achalasia is a rare disorder of the oesophageal smooth muscle characterized by impaired relaxation of the lower oesophageal sphincter (LES) and absent or spastic contractions in the oesophageal body. The key pathophysiological mechanism is loss of inhibitory nerve function that probably results from an autoimmune attack targeting oesophageal myenteric nerves through cell-mediated and, possibly, antibody-mediated mechanisms. Achalasia incidence and prevalence increase with age, but the disorder can affect all ages and both sexes. Read More

Clin Biomech (Bristol, Avon) 2022 May 20;95:105651. Epub 2022 Apr 20.

Department of Materials and Production, Aalborg University, Fibigerstræde 16, DK-9220, Denmark. Electronic address:

Background: Knee osteoarthritis is a progressive disease that may require management for years before knee arthroplasty can be considered. Previously reported musculoskeletal models suggest that rebalancing the strength of the triceps surae muscles can reduce the joint loads.

Methods: A single patient diagnosed with mild/moderate medial left knee osteoarthritis was treated with botulinum toxin injections in the gastrocnemius muscle of the calf, based on the hypothesis that this would rebalance the triceps surae load distribution and reduce tibiofemoral joint loads. Read More

Endosc Int Open 2022 Apr 14;10(4):E521-E527. Epub 2022 Apr 14.

Neurogastroenterology Group, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts & the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

 The management of functional biliary-type pain remains a clinical challenge. Intra sphincteric botulinum toxin putatively exerts an anti-spasmodic and anti-nociceptive effect. The objective of this study was to examine the clinical response to intra sphincteric botulinum toxin in patients with functional biliary-type pain. Read More

J Orthop Case Rep 2021 Dec;11(12):1-4

Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan.

Introduction: The locking compression plate (LCP) system for pediatric hips has improved fixation and angular stability. Herein, we report a rare case in which all proximal locking compression screws were broken before weight bearing in the early post-operative period after derotational femoral osteotomy in a child with spastic cerebral palsy (CP).

Case Report: Derotational femoral osteotomy was performed using a LCP system for a 9-year-old boy with spastic CP to correct excessive femoral anteversion, causing unstable toe-in gait. Read More

Eur J Phys Rehabil Med 2022 Apr 12. Epub 2022 Apr 12.

Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania.

Introduction: The complexity of spasticity requires a continuous effort in terms of more adapted treatments for patients and accurate management. Through this systematic review, we aimed to evaluate and compare the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) with Botulinum Toxin Type A (BoNT-A) on reducing spasticity both in children and adults.

Evidence Acquisition: An electronic search of PubMed/ MEDLINE, Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Read More

J Pediatr Rehabil Med 2022 ;15(1):129-143

Shirley Ryan AbilityLab, Northwestern Feinberg School of Medicine, Chicago, IL, USA.

Purpose: A large prospective database from three Phase 3 studies allowed the study of spasticity-related pain (SRP) in pediatric cerebral palsy (CP).

Methods: Baseline (pretreatment) SRP data occurring during different activities in children/adolescents (aged 2-17 years, ambulant/nonambulant) with uni-/bilateral spastic CP was obtained using the Questionnaire on Pain caused by Spasticity (QPS; six modules specific to spasticity level [lower limb (LL) or upper limb (UL)] and type of respondent [child/adolescent, interviewer, or parent/caregiver]).

Results: At baseline, 331 children/adolescents with LL- and 155 with UL-spasticity completed at least one key item of their modules; LL/UL QPS modules of parent/caregivers were at least partially completed (key items) by 841/444 parents/caregivers. Read More

Biomedicines 2022 Mar 15;10(3). Epub 2022 Mar 15.

Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.

A shock wave (SW), which carries energy and propagates through a medium, is a type of continuous transmitted sonic wave that can achieve rapid energy transformations. SWs have been applied for many fields of medical science in various treatment settings. In urology, high-energy extracorporeal SWs have been used to disintegrate urolithiasis for 30 years. Read More

J Oral Facial Pain Headache 2022 Winter;36(1):6-20

Aims: To systematically review the scientific literature for evidence concerning the clinical use of botulinum toxin (BTX) for the management of various temporomandibular disorders (TMDs).

Methods: A comprehensive literature search was conducted in the Medline, Web of Science, and Cochrane Library databases to find randomized clinical trials (RCT) published between 2000 and the end of April 2021 investigating the use of BTX to treat TMDs. The selected articles were reviewed and tabulated according to the PICO (patients/problem/population, intervention, comparison, outcome) format. Read More

Headache 2022 Mar 16;62(3):306-318. Epub 2022 Mar 16.

VA Connecticut Healthcare System, West Haven, Connecticut, USA.

Background And Objective: Comprehensive headache care involves numerous specialties and components that have not been well documented or standardized. This study aimed to elicit best practices and characterize important elements of care to be provided in multidisciplinary headache centers.

Methods: Qualitative, semi-structured telephone interviews with a purposive sample of headache neurology specialists from across the US, using open-ended questions. Read More

Eur J Pain 2022 05 23;26(5):980-990. Epub 2022 Mar 23.

Pain Unit, Hôpital Raymond Poincaré, APHP, Garches, France.

Background And Objective: Botulinum toxin type A (BTX-A) is a recently developed treatment for the management of peripheral neuropathic pain. The objective of this study was to provide a synthesis of the evidence concerning the efficacy and safety of subcutaneous botulinum toxin type A injections.

Databases And Data Treatment: We searched the MEDLINE, EMBASE, LILACS, Cochrane, and Clinical Trial Register databases for randomized controlled trials comparing subcutaneous BTX-A to placebo injections for treating chronic peripheral neuropathic pain. Read More

Arch Dis Child 2022 Feb 21. Epub 2022 Feb 21.

Royal Devon and Exeter NHS Trust, Children & Young People, Exeter, UK.

For this narrative review, we found recent publications on the use and effectiveness of old therapies including nutraceuticals, such as riboflavin, vitamin D, magnesium, melatonin and talking therapies. Recent large trials of established conventional pharmaceuticals such as propranolol, pizotifen, topiramate and amitriptyline for childhood migraine have failed, but the use of a quasi-placebo in future trials could help. We reviewed the evidence for angiotensin antagonists including candesartan in adults, but found a lack of evidence for their use in children. Read More

Acta Orthop Belg 2021 Dec;87(4):765-769

A challenging complication of arthroscopic biceps surgery is the persistent painful cramping of the biceps. There is a paucity of data upon nonsurgical treatment of this debilitating complication. We pro- pose an intramuscular injection of botulinum toxin A (BTX-A) for painful bicipital cramping after tenotomy of the long head of the biceps brachii tendon (LHBT). Read More

Cranio 2022 Feb 12:1-11. Epub 2022 Feb 12.

Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.

Objective: The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD).

Methods: The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. Read More

Br J Pain 2022 Feb 24;16(1):41-49. Epub 2021 May 24.

The National Hospital for Neurology and Neurosurgery, London, UK.

Aim: This is a retrospective report of the efficacy of botulinum toxin-A, Botox (Allergan), in intractable chronic migraine patients non-responsive to previous pharmacological management and with largely no pain-free time, including those with new onset daily persistent headache.

Methods: Thirty-three patients, all with severe Headache Impact Test (HIT)-6 scores at baseline, received 3-monthly injections of Botox as per Phase III REsearch Evaluating Migraine Prophylaxis Therapy (PRE-EMPT) protocol over a maximum 33-month period. Response criteria were a sustained reduction of HIT-6 scores below 60. Read More

Knee Surg Relat Res 2022 Feb 1;34(1). Epub 2022 Feb 1.

Sackler Faculty of Medicine, Tel Aviv University, P. O. Box 39040, 6997801, Tel Aviv, Israel.

J Pers Med 2022 Jan 13;12(1). Epub 2022 Jan 13.

Department of Gynecologic Surgery, Puerta de Hierro University Hospital, 28222 Madrid, Spain.

Background: Although several treatments are currently available for chronic pelvic pain, 30-60% of patients do not respond to them. Therefore, these therapeutic options require a better understanding of the mechanisms underlying endometriosis-induced pain. This study focuses on pain management after failure of conventional therapy. Read More

Anesth Analg 2022 Jun 20;134(6):1215-1228. Epub 2022 Jan 20.

Pain Management, Anesthesiology Institute.

Background: Painful diabetic neuropathy (PDN) is one of the major complications of diabetes mellitus. It is often debilitating and refractory to pharmaceutical therapies. Our goal was to systematically review and evaluate the strength of evidence of interventional management options for PDN and make evidence-based recommendations for clinical practice. Read More

Toxins (Basel) 2022 01 1;14(1). Epub 2022 Jan 1.

Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Piazzale Aristide Stefani 1, 37126 Verona, Italy.

Introduction: Pain management of patients with chronic pelvic pain syndrome (CPPS) is challenging, because pain is often refractory to conventional treatments. Botulinum toxin A (BTX-A) may represent a promising therapeutic strategy for these patients. The aim of this systematic review was to investigate the role of BTX-A in CPPS treatment. Read More

Reg Anesth Pain Med 2022 05 17;47(5):322-326. Epub 2022 Jan 17.

Yonsei University Medical Center, Seodaemun-gu, Korea

Introduction: The use of the botulinum neurotoxin injection is a growing area of research and clinical activity, with a focus on its role in facilitating postoperative pain management after reconstructive breast surgery. The study aimed to find out the standard injection points for botulinum neurotoxin injection by revealing the intramuscular nerve arborization of the pectoralis major.

Methods: Sihler's technique was conducted on the pectoralis major muscles (16 cadaveric specimens). Read More

Lancet Digit Health 2022 02 13;4(2):e76-e77. Epub 2022 Jan 13.

Scientific Consulting Group, Gaithersburg, MD, USA; Office of the Clinical Director, Intramural Research Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA. Electronic address:

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(11):39-48

Interregional Clinical and Diagnostic Center, Kazan, Russia.

Objective: To assess the longitudinal attainment of patient-centred and function related goals after integrated spasticity management including repeated cycles of botulinum toxin A type A (BoNT-A) injections in real life settings over a period of 2 years. The article presents analysis of the results within the subpopulation of patients from Russia.

Material And Methods: This international, multicentre, observational, prospective, longitudinal cohort study (registered at clinicaltrials. Read More

eNeurologicalSci 2021 Dec 27;25:100374. Epub 2021 Oct 27.

Clinical Planning and Development, Medical HQs, Eisai Co., Ltd., 4-6-10 Koishikawa, Bunkyo-ku, Tokyo, Japan.

To date, efficacy data on botulinum toxin type B (rimabotulinumtoxinB) in patients with cervical dystonia (CD) previously treated with botulinum toxin type A in a large population are lacking; thus, we aimed to evaluate type B efficacy in this patient population. In a post-marketing observational cohort study, 150 patients previously treated with botulinum toxin type A were enrolled, of whom 138 were followed up for 1 year after the initial type B injection. Final observation data were available for 122 patients. Read More

South Med J 2021 12;114(12):777-782

From the University of Florida College of Medicine, Jacksonville.

As medical care advances, there is a growing number of adult patients with cerebral palsy. The spastic form is characterized by muscle hypertonicity, hyperreflexia, and spasticity, which are associated with worse quality of life, poor functionality, and pain. This literature review attempts to explore the existing treatments for spasticity in cerebral palsy to provide insight into potential treatments in the adult population. Read More

BMJ Case Rep 2021 Nov 30;14(11). Epub 2021 Nov 30.

Physical Medicine and Rehabilitation, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA

A 64-year-old woman presented to an academic medical centre with postoperative left ischial pain following a left total hip replacement. Her pain was exacerbated by sitting down and with forward flexion of the spine, and the pain radiated from the left ischial tuberosity to the left perineum, groin and medial thigh. An ischial bursa injection was performed, but only resulted in 1 day of excellent pain relief. Read More