Evidence map›Paper›PMID 40598650›Full record

ArticleJournal of medical case reports2025

Botulinum toxin A injections and adverse effects to mimic muscle in TMD myofascial pain treatment: a case report.

Elina Alvesalo, Pentti Kemppainen, Olli Teronen, Antti Kämppi, Victoria Sitnikova

Abstract readCase Reports
In one paragraph

Article in Journal of medical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elina AlvesaloDepartment of Oral and Maxillofacial Diseases Faculty of Medicine, University of Helsinki, Haartmaninkatu 1 (PL41), 00014, Helsinki, Finland. elina.alvesalo@gmail.com.ORCID http://orcid.org/0009-0008-7911-7346
Pentti KemppainenDepartment of Oral and Maxillofacial Diseases Faculty of Medicine, University of Helsinki, Haartmaninkatu 1 (PL41), 00014, Helsinki, Finland.
Olli TeronenDepartment of Oral and Maxillofacial Diseases Faculty of Medicine, University of Helsinki, Haartmaninkatu 1 (PL41), 00014, Helsinki, Finland.
Antti KämppiDepartment of Oral and Maxillofacial Diseases Faculty of Medicine, University of Helsinki, Haartmaninkatu 1 (PL41), 00014, Helsinki, Finland.
Victoria SitnikovaDepartment of Oral and Maxillofacial Diseases Faculty of Medicine, University of Helsinki, Haartmaninkatu 1 (PL41), 00014, Helsinki, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBotulinum toxin A is an increasingly used drug in the treatment of temporomandibular disorders and chronic myofascial pain. Although the treatment is safe, and the procedure is fairly simple, adverse effects can occur. In this case report, we discuss a 37 -year-old, Finnish female patient in whom m. Risorius was temporarily paralyzed by botulinum toxin A injections. According to the study protocol the injections were applied bilaterally to the masseter and temporalis muscles. Represented adverse effects of botulinum toxin A injections are rare according to current literature and therefore it is important to bring this matter up especially from an educational point of view. CASE PRESENTATION: This case report describes a case of a 37 -year-old, Finnish female patient who participated in a randomized clinical trial of botulinum toxin A in patients suffering from temporomandibular disorders, more detailed myalgia and headache attributed to temporomandibular disorders conducted in Helsinki University. The patient reported pain in the face area every day for the last 6 months (Diagnostic Criteria for Temporomandibular Disorders Axis II survey) before entering the study. She had had a night splint, more detailed a Michigan splint in the upper jaw, for 1 year and 3 months and had tried selfcare instructions, such as massage and movement therapies, as well as physical therapy with moderate success. Treatment modalities provided only temporary relief for the existing problem.

conclusionEven though the patient experienced adverse effects (temporary paralysis of the m.Risorius) after the botulinum toxin A injections she also experienced a noticeable reduction in muscle pain and headache attributed to temporomandibular disorders after the injections and after 6 months still reported reduced pain in the head and neck area. (characteristic pain intensity and graded chronic pain scale values were lower than before the study). Although the paper indicates possible positive outcomes of botulinum toxin A injections for patients suffering from myalgia in mastication muscles and temporomandibular disorders associated headache, there are also adverse effects to consider before making any decision on botulinum toxin A injections.

Indexed as

Botulinum Toxins, Type AMyalgiaNeuromuscular AgentsTemporomandibular Joint DisordersTemporomandibular Joint Dysfunction SyndromeAdultFemaleHeadacheHumansInjections, IntramuscularMasseter MuscleTemporal MuscleBotulinum Toxins, Type ANeuromuscular AgentsAdverse effectsBotulinum toxin A (BonT-a)Temporomandibular disorders (TMD)

Identifiers

PMID40598650
PMCPMC12211189

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.