Botox (also available as product called Dysport) is used by me in the pain clinic only for the treatment of neuropathic scar pain and for greater occipital nerve blocks to hopefully provide long term relief from Migraine and the Trigeminal Cephalalgias.
Botox is a drug that causes irreversibly paralysis to the muscle it comes in contact with by binding synaptic Acetyl Choline receptors. The paralysis reverses only when new receptors are made.
Botox also appears to have an effect on the production of noxious substances that cause the sensation of neuropathic pain in the periphery and is associated with the signs of allodynia or pain without a painful stimulus to the skin.
Scar Pain
It is my clinical experience that Botox will stop scar pain when allodynia is present indefinitely. It can also be used to reduce the size of unsightly scars (known as keloid scars).
Migraine relief
Botox to the area of the Greater Occipital nerves is part of the pathway for the treatment of the headache syndromes including Migraine. Failure to respond is an indication for consideration for Occipital verve stimulation.
