Dilution of botulinum toxin type A in local anesthetics: a therapeutic opportunity in migraine treatment

Authors

DOI:

https://doi.org/10.48208/HeadacheMed.2024.12

Keywords:

Anesthetics , Pain, Headache, BotulinumtoxinA

Abstract

Botulinum Toxin (BoNT) type A, derived from Clostridium botulinum, is widely employed in neurology for its muscle-paralyzing effects. Concurrently, local anesthetics like lidocaine offer regional pain relief. Combining BoNT-A with local anesthetics could enhance therapeutic efficacy, particularly in headache disorders. We conducted a systematic review following PRISMA guidelines, searching various databases for relevant studies. Among the 1,623 articles initially identified, 13 met inclusion criteria. Notably, no trials specifically addressed BoNT-A dilution in local anesthetics for headaches. However, studies in other contexts revealed promising findings. For instance, blending BoNT-A with Lidocaine and epinephrine demonstrated superior pharmacological properties compared to saline reconstitution. Nonetheless, caution is warranted, as fatal outcomes have been reported with BoNT-A and lidocaine administration. While the literature on BoNT-A diluted in local anesthetics for migraines is scarce, existing evidence suggests potential benefits akin to other disorders. Reconstituting BoNT-A in lidocaine offers a promising avenue for optimizing headache treatment, warranting further investigation in future research endeavors.

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References

Barbanti P, Ferroni P. Onabotulinum toxin A in the treatment of chronic migraine: patient selection and special considerations. J Pain Res. 2017;10:2319-29. Doi 10.2147/JPR.S113614 DOI: https://doi.org/10.2147/JPR.S113614

Seibel CB, Scarimbolo MG. Toxina BotulÍnica DiluÍda Com LidocaÍna + Epinefrina: Relato De Casos. Aesthetic Orofacial Science. 2022;3(3):47-54. Doi 10.51670/aos.v3i3.125 DOI: https://doi.org/10.51670/aos.v3i3.125

Colhado OCG, Boeing M, Ortega LB. Botulinum Toxin in Pain Treatment. Brazilian Journal of Anesthesiology. 2009;59(3):366-81. Doi 10.1590/s0034-70942009000300013 DOI: https://doi.org/10.1590/S0034-70942009000300013

Raciti L, Raciti G, Militi D, Casella C, Calabro RS. Chronic Migraine: A Narrative Review on the Use of Botulinum Toxin with Clinical Indications and Future Directions. J Integr Neurosci. 2022;21(5):141. Doi 10.31083/j.jin2105141 DOI: https://doi.org/10.31083/j.jin2105141

Scott AB. Botulinum Toxin Injection into Extraocular Muscles as an Alternative to Strabismus Surgery. Ophthalmology. 1980;87(10):1044-9. Doi 10.1016/s0161-6420(80)35127-0 DOI: https://doi.org/10.1016/S0161-6420(80)35127-0

Dressler D, Adib Saberi F, Bigalke H. Botulinum toxin therapy: reduction of injection site pain by pH normalisation. J Neural Transm (Vienna). 2016;123(5):527-31. Doi 10.1007/s00702-016-1522-9 DOI: https://doi.org/10.1007/s00702-016-1522-9

Schulman JM, Strichartz GRJGD, Tashjian Jr AH, Armstrong EJ, Armstrong AW. Princípios de Farmacologia: a base fisiopatológica da farmacoterapia. Farmacologia dos anestésicos locais. 2009;2:131-45. Doi

Vadoud-Seyedi J, Simonart T. Treatment of axillary hyperhidrosis with botulinum toxin type A reconstituted in lidocaine or in normal saline: a randomized, side-by-side, double-blind study. Br J Dermatol. 2007;156(5):986-9. Doi 10.1111/j.1365-2133.2007.07760.x

Çakmak M, Caglayan F, Somuncu S, Leventoglu A, Ulusoy S, Akman H, et al. Effect of paralysis of the abdominal wall muscles by botulinum A toxin to intraabdominal pressure: an experimental study. Journal of Pediatric Surgery. 2006;41(4):821-5. Doi 10.1016/j.jpedsurg.2005.12.023 DOI: https://doi.org/10.1016/j.jpedsurg.2005.12.023

Gassner HG, Sherris DA. Addition of an Anesthetic Agent to Enhance the Predictability of the Effects of Botulinum Toxin Type A Injections: A Randomized Controlled Study. Mayo Clinic Proceedings. 2000;75(7):701-4. Doi 10.4065/75.7.701 DOI: https://doi.org/10.1016/S0025-6196(11)64616-8

Vadoud-Seyedi J, Simonart T. Treatment of axillary hyperhidrosis with botulinum toxin type A reconstituted in lidocaine or in normal saline: a randomized, side-by-side, double-blind study. British Journal of Dermatology. 2007;156(5):986-9. Doi 10.1111/j.1365-2133.2007.07760.x DOI: https://doi.org/10.1111/j.1365-2133.2007.07760.x

Toledo SdO, Felippe RMS, Reis BCC. Reação anafilática em uso de anestésicos locais: uma revisão de literatura. Revista Eletrônica Acervo Médico. 2022;14. Doi 10.25248/reamed.e10743.2022 DOI: https://doi.org/10.25248/reamed.e10743.2022

McLaughlin B, Alvarez K, Hilario M, Hersh EV, Bina B. True Allergy to Amide Local Anesthetics: A Review and Case Presentation. Anesthesia Progress. 2018;65(2):119-23. Doi 10.2344/anpr-65-03-06 DOI: https://doi.org/10.2344/anpr-65-03-06

Li M, Goldberger BA, Hopkins C. Fatal case of BOTOX-related anaphylaxis? J Forensic Sci. 2005;50(1):169-72. Doi DOI: https://doi.org/10.1520/JFS2004196

Murray C, Solish N. Metallic taste: an unusual reaction to botulinum toxin A. Dermatol Surg. 2003;29(5):562-3. Doi 10.1046/j.1524-4725.2003.29131.x DOI: https://doi.org/10.1046/j.1524-4725.2003.29131.x

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Published

2024-06-29

How to Cite

1.
Nogueira E de AG, Piovesan EJ, Peres MFP. Dilution of botulinum toxin type A in local anesthetics: a therapeutic opportunity in migraine treatment. Headache Med [Internet]. 2024 Jun. 29 [cited 2024 Oct. 6];15(2):43-6. Available from: https://headachemedicine.com.br/index.php/hm/article/view/1041

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