Assessing the Efficacy of Botulinum Toxin in Treating Neuropathic Pain: A Report of Two Cases

This study examines the efficacy of botulinum neurotoxin type A (BoNT-A) in neuropathic pain management. Neuropathic pain (NP) is a chronic condition that remains challenging to treat. While botulinum neurotoxin type A (BoNT-A) has been proposed as a therapeutic option, its efficacy in trauma-induced NP remains unclear. This report presents two patients with NP in their fingers - one following a traumatic amputation and the other a sharp laceration - who underwent two sessions of BoNT-A injections. Neither patient experienced improvement in pain severity or functionality, and severe allodynia persisted. These findings suggest that BoNT-A may have limited efficacy in certain neuropathic pain conditions, emphasizing the need for careful patient selection and further research into alternative therapeutic strategies. Additionally, this study introduces the "neuropathic finger" as a model for investigating local drugs with potential antineuropathic properties.