Antinociceptive Effects of Botulinum Toxin Type-a in Pain and Headaches Treatment

Since its development for clinical use in 1980s botulinum toxin, the most potent biological toxin known to man has become a useful drug in various field of medicine. It was initially used to treat neurological disorders characterized by excessive muscle contractions. Since many patients report alleviation of pain before the muscle relaxing effect of botulinum toxin type-A has started, a direct analgesic action of Botulinum toxin has been discussed. There have been a number of recent investigations concerning the efficacy of botulinum toxin type-A applications for treatment of headache and chronic pain. Most of the known effect of botulinum toxin has been attributed to its ability to inhibit the release of acetylcholine from cholinergic nerve terminal. However, this effect alone does not explain the apparent antinociceptive effect of botulinum toxin. Other peripheral and central neurogenic effect should be considered. Current data suggest that Botulinum toxin is safe and effective in headache and pain treatment if used in specialist centres by experienced doctors.