Article Text
Abstract
Three patients ranging from 49 to 61 years-old presented to our pain clinic after failing multiple treatment attempts for debilitating, chronic post-traumatic headaches, neck pain and involuntary muscle spasm following gunshot wounds to the head, neck and face. Concurrent cervical dystonia was noted in each patient on presentation. All patients were treated with onabotulinumtoxin A (ONA) injections in the head and neck. Each patient reported between 70% and 100% improvement of their headache pain, neck pain and spasm with a significant reduction in the frequency, duration and intensity of their headaches. This level of improvement has been successfully maintained in all three patients with regular ONA injections at 90-day intervals. Two patients experienced a single relapse in symptoms when scheduling conflicts caused them to miss their regularly scheduled ONA injections by several weeks. These symptoms resolved when their ONA injections resumed, suggesting that ONA is the causative agent alleviating their symptoms.
- pain
- botulinum toxin
- headache (including migraines)
- movement disorders (other than parkinsons)
- trauma CNS /PNS
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Footnotes
Contributors TKG devised the project, and provided the resources and materials needed. TKG administered all of the onabotulinumtoxin A injections. LPF, DS and RA contributed to the literature search, analysis and interpretation. LPF wrote the manuscript in consultation with DS, RA and TKG. All authors provided critical feedback and helped shape the research, analysis and manuscript. TKG supervised the project.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.