Observational studyThe journal of headache and pain2024
Efficacy and safety profile of Onabotulinum toxin-A injection at sphenopalatine ganglion in trigeminal neuralgia: a prospective observational study.
Observational study in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Advanced, pharmacological and complementary interventions for chronic or recurrent orofacial pain conditions: a systematic evidence map with selective meta-analyses.The journal of headache and pain · 2026Pooled it
- Advances in orofacial pain research: a bibliometric analysis.Frontiers in neurology · 2025Pooled it
- Emerging Pharmacological Strategies for Trigeminal Neuralgia.CNS drugs · 2026Review
- Review
- Focused Modulation of Brain Activity: A Narrative Review.Biomedicines · 2025Review
- Sphenopalatine Ganglion Blocks in Headache Management: A Review.Brain sciences · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe sphenopalatine ganglion (SPG) plays a role in orofacial pain and headaches and is a target for pain modulation. Onabotulinum toxin-A injections have been described as a treatment for several neuropathic pain conditions. However, there is limited evidence for using this medication at the sphenopalatine ganglion for orofacial pain. The goal of this study was to investigate the effectiveness, in terms of pain intensity and frequency of pain attacks, as well as the safety of fluoroscopy-guided Onabotulinum toxin-A injection administered directly to the sphenopalatine ganglion in patients with trigeminal neuralgia.
methodFourteen patients diagnosed with trigeminal neuralgia who either could not tolerate the side effects of oral medication or did not respond to oral medication. Onabotulinum toxin-A 40 units was injected through the sphenopalatine ganglion under fluoroscopy guidance. The primary outcome was a reduction in pain intensity (using the Numerical Rating Scale). The secondary outcome was a reduction in the frequency of pain attack and safety profile of the procedure.
resultsThe average pain scores and frequency of pain decreased significantly (p-value < 0.001). The mean baseline pain score before the injection was 8.15 ± 1.91. The mean pain score reduction 60 days after the procedure was 4.15 (95% CI: 2.72, 5.59; p < 0.001). The frequency of pain attacks also decreased significantly from 12.15 ± 8.61 times per day to 3.38 ± 2.53 times per day at 60 days after the procedure (p < 0.001). Complications directly associated with the procedure included hemifacial palsy (76.9%) and diplopia (7.7%). These symptoms resolved within three months after the procedure.
conclusionOnabotulinum toxin-A injection at the SPG is effective in reducing pain symptoms in trigeminal neuralgia patients who cannot tolerate the side effects of medication or are refractory to oral medication.
trial registrationThis study was retrospectively registered in the Thai Clinical Trial Registry under registration number TCTR20240908004 on 3 September 2024.
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