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Intralesional Injection of Botulinum Toxin for Post-Herpetic Neuralgia: A Pilot Study

Background: When someone has herpes zoster and the rash goes away in spite of persistence of pain, they are defined to have post-herpetic neuralgia (PHN). Herpes zoster is frequently accompanied by post-herpetic neuralgia. Clostridium botulinum produces botulinum toxin (BTX-A), a neurotoxic protein that is used to treat various ailments. Objective: Intralesional botulinum toxin injections were tested for their efficacy in the treatment of post herpetic neuralgia. Patients and methods: An intralesional BTX-A injections pilot trial including 19 patients with PHN was carried out. Quality of life scale (QLS), neuropathy pains scale (NPS), and pain analyses by visual analogue scale (VAS) were used for all patients after comprehensive history-taking process. Results: After a six-months therapy follow-up period, we found significant differences comparing before and after treatment in the neuropathy pain scale, VAS score, and the QLS (SF-36). Pain at site of injection was found in all patients while redness or erythema was found in 13 patients. Conclusion: Treatment with botulinum toxin via local injection is beneficial for post-herpetic neuralgia (PHN). BTX could be alternative therapeutic modality in treating PHN in the future.