Dilution of botulinum toxin type A in local anesthetics: a therapeutic opportunity in migraine treatment
DOI:
https://doi.org/10.48208/HeadacheMed.2024.12Keywords:
Anesthetics , Pain, Headache, BotulinumtoxinAAbstract
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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Copyright (c) 2024 Eduardo de Almeida Guimarães Nogueira, Elcio Juliato Piovesan, Mario Fernando Prieto Peres (Author)
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