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Toxins 2015, 7(8), 3127-3154;

Botulinum Toxin for Neuropathic Pain: A Review of the Literature

Department of Rehabilitation Medicine, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Department of Rehabilitation Medicine, St. Paul’s Hospital, College of Medicine, the Catholic University of Korea, Wangsan-ro 180, Dongdaemoon-Gu, Seoul 02559, Korea
Author to whom correspondence should be addressed.
Academic Editor: Bahman Jabbari
Received: 27 June 2015 / Revised: 29 July 2015 / Accepted: 7 August 2015 / Published: 14 August 2015
(This article belongs to the Collection Botulinum Toxins on Human Pain)
PDF [670 KB, uploaded 14 August 2015]


Botulinum neurotoxin (BoNT), derived from Clostridium botulinum, has been used therapeutically for focal dystonia, spasticity, and chronic migraine. Its spectrum as a potential treatment for neuropathic pain has grown. Recent opinions on the mechanism behind the antinociceptive effects of BoNT suggest that it inhibits the release of peripheral neurotransmitters and inflammatory mediators from sensory nerves. There is some evidence showing the axonal transport of BoNT, but it remains controversial. The aim of this review is to summarize the experimental and clinical evidence of the antinociceptive effects, mechanisms, and therapeutic applications of BoNT for neuropathic pain conditions, including postherpetic neuralgia, complex regional pain syndrome, and trigeminal neuralgia. The PubMed and OvidSP databases were searched from 1966 to May 2015. We assessed levels of evidence according to the American Academy of Neurology guidelines. Recent studies have suggested that BoNT injection is an effective treatment for postherpetic neuralgia and is likely efficient for trigeminal neuralgia and post-traumatic neuralgia. BoNT could also be effective as a treatment for diabetic neuropathy. It has not been proven to be an effective treatment for occipital neuralgia or complex regional pain syndrome. View Full-Text
Keywords: botulinum toxins; BoNT/A; neuropathic pain; neuralgia; antinociceptive botulinum toxins; BoNT/A; neuropathic pain; neuralgia; antinociceptive

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Oh, H.-M.; Chung, M.E. Botulinum Toxin for Neuropathic Pain: A Review of the Literature. Toxins 2015, 7, 3127-3154.

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