Effect of Botulinum Toxin A on Acute and Chronic Pain in Herpes Zoster Patients

Han, Gil; Kim, Soo Hyun; Lee, Kyu Suk; Cho, Jae We

Abstract

BACKGROUND
Many strategies are currently used to reduce herpes zoster pain, such as opioid analgesic administration and transcutaneous electrical nerve stimulation. However, a more effective and convenient method to reduce herpes zoster pain is needed.
OBJECTIVE
The purpose of this study is to evaluate the efficacy and safety of botulinum toxin A in patients with herpes zoster pain.
METHODS
Seventy-five patients with herpes zoster pain were enrolled. We reviewed the medical records and divided the patients into three groups according to the treatment they received: standard treatment with botulinum toxin A, standard treatment only, and standard treatment with normal saline injection. Data on patients' age, sex, involved dermatome, and the duration and severity of pain evaluated with the visual analogue scale (VAS) were collected. Botulinum toxin A (1 unit/1 cm2, total 10~20 units) was injected intradermally, and the patients were evaluated on initial visit, and at 1 and 28 days after injection.
RESULTS
In concordance with previous studies, this study showed that botulinum toxin A had a rapid and considerable effect on reducing both acute and postherpetic pain. The mean VAS was 6.96 on initial visit, 2.90 after 1 day, and 2.03 after 28 days in the botulinum toxin injection group. This result was statistically significant (p<0.001) when compared with the standard treatment group and the standard treatment with normal saline injection group. Few adverse effects were observed.
CONCLUSION
Intradermal injection of botulinum toxin A is an effective and safe method for reducing pain in patients with herpes zoster.