The use of botulinum toxin type A in the treatment of chronic drug-resistant pain in a patient with type 1 neurofibromatosis
O. R. Orlova,
P. N. Iakovleva,
M. A. Akulov,
А. А. Tomsky,
A. F. Ivolgin,
E. S. Makashova,
E. D. Isagulyan https://doi.org/10.14412/2074-2711-2026-3-73-77
Abstract
Chronic pain remains one of the most challenging issues in the management of patients with type 1 neurofibromatosis (NF1), significantly reducing their quality of life. The aetiology of pain in NF1 is multifactorial and not fully understood, which complicates the selection of effective treatment. Current treatment methods – pharmacotherapy, surgical removal of tumours and neuromodulation – do not always provide a lasting analgesic effect and are associated with a risk of complications or recurrence of pain. The clinical case presented demonstrates the successful treatment of severe, drug-resistant pain syndrome in a patient with NF1 using botulinum toxin type A (incobotulinumtoxin). The use of botulinum toxin type A under ultrasound guidance resulted in a significant reduction in pain intensity, a decrease in the frequency of pain episodes, and an improvement in the patient’s quality of life, with no adverse events. Thus, we report for the first time the use of incobotulinumtoxin in NF1 with a positive clinical outcome.
Keywords
Supporting agencies: The article is sponsored by Merz.
About the Authors
O. R. Orlova
Central Institute of Botulinum Therapy and Current Neurology ; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
6, Marshala Rokossovskogo Blvd., Build. 1, Moscow 107370
8, Trubetskaya St., Build. 2, Moscow 119048
Competing Interests:
The conflict of interests did not affect the results of the study.
P. N. Iakovleva
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
Polina Nikolaevna Iakovleva
8, Trubetskaya St., Build. 2, Moscow 119048
Competing Interests:
The conflict of interests did not affect the results of the study.
M. A. Akulov
N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
16, 4th Tverskaya-Yamskaya St., Moscow 125047
Competing Interests:
The conflict of interests did not affect the results of the study.
А. А. Tomsky
N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
16, 4th Tverskaya-Yamskaya St., Moscow 125047
Competing Interests:
The conflict of interests did not affect the results of the study.
A. F. Ivolgin
National Medical Research Center for High Medical Technologies – A.A. Vishnevsky Central Military Clinical Hospital, Ministry of Defence of Russia
Russian Federation
Competing Interests:
Russian Federation
1, Novyi Set., Krasnogorsk, Moscow Region, 143420
Competing Interests:
The conflict of interests did not affect the results of the study.
E. S. Makashova
N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
16, 4th Tverskaya-Yamskaya St., Moscow 125047
Competing Interests:
The conflict of interests did not affect the results of the study.
E. D. Isagulyan
N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
16, 4th Tverskaya-Yamskaya St., Moscow 125047
Competing Interests:
The conflict of interests did not affect the results of the study.
References
1. Coy S, Rashid R, Stemmer-Rachamimov A, Santagata S. An update on the CNS manifestations of neurofibromatosis type 2. Acta Neuropathol. 2020;139(4):643-65. doi: 10.1007/s00401-019-02029-5
2. Nix JS, Blakeley J, Rodriguez FJ. An update on the central nervous system manifestations of neurofibromatosis type 1. Acta Neuropathol. 2020;139(4):625-41. doi: 10.1007/s00401-019-02002-2
3. Kresak JL, Walsh M. Neurofibromatosis: A Review of NF1, NF2, and Schwannomatosis. J Pediatr Genet. 2016;5(2):98-104. doi: 10.1055/s-0036-1579766
4. Campian J, Gutmann DH. CNS Tumors in Neurofibromatosis. J Clin Oncol. 2017;35(21):2378-85. doi: 10.1200/JCO.2016.71.7199
5. Bellampalli SS, Khanna R. Towards a neurobiological understanding of pain in neurofibromatosis type 1: mechanisms and implications for treatment. Pain. 2019;160(5):1007-18. doi: 10.1097/j.pain.0000000000001486
6. Farschtschi S, Mautner VF, McLean ACL, et al. The Neurofibromatoses. Dtsch Arztebl Int. 2020;117(20):354-60. doi: 10.3238/arztebl.2020.0354
7. Da Cunha PHM, Lapa JDDS, Hosomi K, de Andrade DC. Neuromodulation for neuropathic pain. Int Rev Neurobiol. 2024;179:471-502. doi: 10.1016/bs.irn.2024.10.013
8. Finnerup NB, Attal N, Haroutounian S, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14(2):162-73. doi: 10.1016/S1474-4422(14)70251-0
9. Taheri M, Sedaghat M, Solhpour A, et al. The Effect of Intradermal Botulinum Toxin a injections on painful diabetic polyneuropathy. Diabetes Metab Syndr. 2020;14(6):1823-8. doi: 10.1016/j.dsx.2020.09.019
10. Chen L, Zhang Y, Chen Y, et al. Efficacy and Safety of Botulinum Toxin A and Pulsed Radiofrequency on Postherpetic Neuralgia: A Randomized Clinical Trial. Contrast Media Mol Imaging. 2022;2022:1579937. doi: 10.1155/2022/1579937
11. Tsai CP, Liu CY, Lin KP, Wang KC. Efficacy of botulinum toxin type A in the relief of Carpal tunnel syndrome: A preliminary experience. Clin Drug Investig. 2006;26(9):511-5. doi: 10.2165/00044011-200626090-00004
12. Zhang H, Lian Y, Xie N, et al. Single-dose botulinum toxin type a compared with repeated-dose for treatment of trigeminal neuralgia: a pilot study. J Headache Pain. 2017;18(1):81. doi: 10.1186/s10194-017-0793-3
13. De Icco R, Perrotta A, Berra E, et al. OnabotulinumtoxinA Reduces Temporal Pain Processing at Spinal Level in Patients with Lower Limb Spasticity. Toxins (Basel). 2019;11(6):359. doi: 10.3390/toxins11060359
14. Matak I, Bölcskei K, Bach-Rojecky L, Helyes Z. Mechanisms of Botulinum Toxin Type A Action on Pain. Toxins (Basel). 2019;11(8):459. doi: 10.3390/toxins11080459
15. Esipov AV, Ivolgin AF, Avseitseva TYu, et al. Experience in the use of botulinum toxin type A in the treatmentof post-amputation pain syndromes. Gospital'naya medicina: nauka i praktika. 2023;6(3):32-7 (In Russ.). doi: 10.34852/GM3CVKG.2023.18.90.026
Review
For citations:
Orlova OR, Iakovleva PN, Akulov MA, Tomsky АА, Ivolgin AF, Makashova ES, Isagulyan ED. The use of botulinum toxin type A in the treatment of chronic drug-resistant pain in a patient with type 1 neurofibromatosis. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2026;18(3):73-77. (In Russ.) https://doi.org/10.14412/2074-2711-2026-3-73-77
Views:
129
JATS XML
Email this article 