Abstract
Objective: The objective of this case series was to describe botulinum toxin therapy as a novel treatment of intractable head pain following lateral skull base surgery. Background: Intractable headaches following lateral skull base surgery are described in 23%-75% of patients and can significantly impact quality of life. Currently, the etiology of the headaches is unclear and treatment options are limited. Botulinum toxin is indicated for a multitude of functional and cosmetic reasons, including chronic migraine, and has been further described in treatment of various postsurgical pain syndromes. Methods: In this case series, 4 patients underwent subcutaneous peri-incisional injections of botulinum toxin for intractable headache and head pain syndromes. Three patients had undergone lateral skull base surgery and the fourth patient had undergone a temporoparietal fascial flap harvest. Average injection dose ranged from 20 to 60 units with an average duration of effect ranging from 2 weeks to 4 months. Results: All patients experienced significant relief of chronic head pain and returned for additional peri-incisional botulinum toxin injections, suggesting meaningful patient-perceived value. Conclusions: Botulinum toxin therapy may represent a novel treatment for intractable head pain following lateral skull base surgery and temporoparietal fascial flap harvest. This study represents a small case series and, although 100% of the patients who were treated significantly improved, future inquiry is necessary to confirm these findings.
Original language | English (US) |
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Pages (from-to) | 1624-1630 |
Number of pages | 7 |
Journal | Headache |
Volume | 59 |
Issue number | 9 |
DOIs | |
State | Published - Oct 1 2019 |
Externally published | Yes |
Keywords
- botulinum A toxin
- botulinum toxin
- craniotomy
- intractable headache
- postoperative pain
- skull base neoplasms
ASJC Scopus subject areas
- Neurology
- Clinical Neurology