Botulinum For Post Herpetic Neuralgia (PHN)

I had a recent question on treatments for PHN…I felt I needed to add more info on Botox for PHN. (Using equivalents) Putting equivalent of 6 units Botox INTRADERMAL per 3.56 cm diameter (1.4 of an inch) diameter area, could result in 35% drop in pain (like 8 to 5.2/10 VAS). The benefits are apparent by 2nd day and lasting 7.4 weeks. I would consider it an adjunct to other treatments but 35% is as good or better as one would get from painkillers.

Liu, Hsu‐Tang, et al.
Botulinum Toxin A Relieved Neuropathic Pain in a Case of Post‐Herpetic Neuralgia.
Pain Medicine 7.1 (2006): 89-91.

  • mean age 60
  • Pain duration average of 6.4 months (note – they would take cases after 1 month shingles which is not considered post yet).
  • took vial of Dysport (I presume the 500 units) and dissolved it in 4 mls 2% lidocaine) – that would be like Botox 100 unit bottle dissolved in 2 mls
  • Injected 15 units Dysport (6 units Botox) into 10 cm squared area = 3.16 cm by 3.16 cm – or easier to remember –  a 3.56 cm diameter (1.4 of an inch) diameter area. That would be 1.2 mls per this area. (or 4.3 units Botox per inch diameter = 0.86 mls per inch diameter area of 5 u/ml Botox – or 1.7 unit Botox in 1 cm diameter area = 0.3 mls intradermal
  • Given that it was intradermal – skin should blanch white while injecting.

Results – they graphed by % change – I changed it to VAS pain, presuming it started at 8/10. Pain was better by day two “Pain on the second day (p=0.007)”

Comments – Had a very old lady that got terrible pain from shingles and was just over the acute phase – just seen for first time.  Dr. Lang, an anesthetist, kindly  put in a steroid epidural at level, and I gave botox – more subcut to multiple areas.  She lived fine.  It would seem that one would need 200 units Botox for bigger chest areas. It is a myth Botox last 12 weeks  –  they got 7.4 weeks only – going to need repeats at 7+ weeks so better mark the calender – otherwise they will come back at 9 weeks screaming in pain – never a good idea. Pain given intradermal is unlikely to cause muscle paralysis and could be hence useful on face. canada goose femme occasion canada goose femme occasion

This entry was posted in post herpetic neuralgia. Bookmark the permalink.

4 Responses to Botulinum For Post Herpetic Neuralgia (PHN)

  1. Cecilia3052 says:

    It’s really a nice and useful piece of info. I’m happy that you simply shared this helpful information with us. Please stay us informed like this. Thanks for sharing.

  2. Admiring the hard work you put into your site and detailed information you provide. It’s good to come across a blog every once in a while that isn’t the same outdated rehashed material. Great read! I’ve saved your site and I’m including your RSS feeds to my Google account.

  3. What i don’t understood is actually how you are no longer really a lot more smartly-preferred than you may be right now. You’re very intelligent. You realize thus considerably in relation to this matter, produced me personally believe it from a lot of various angles. Its like women and men don’t seem to be fascinated until it is one thing to accomplish with Girl gaga! Your own stuffs great. All the time take care of it up!

Leave a Reply

Your email address will not be published.