Introduction: Botulinum toxin type A has been used in a wide range of neurological diseases such as migraine, cervical dystonia, spasticity or tics. However, the use of this drug in the treatment of neuropathic pain is still uncommon despite the fact that more and more cases supporting its role as an alternative treatment are emerging in the literature.
Case report: Herein, we report a case of an 83 year old woman who suffered from severe pain with neuropathic characteristics due to postherpetic neuralgia which was refractory to different conventional therapies. The neuropathic pain was dramatically improved by multiple botulinum toxin type A injections and the analgesia lasted 2 months. Treatment was well tolerated and there were no side effects.
Conclusions: Using botulinum toxin has been effective and well tolerated in the treatment of postherpetic neuralgia in our patient. Despite the fact that its action mechanisms is still unknown, we consider that botulinum neurotoxin may be an alternative treatment in relieving refractory neuropathic pain and that controlled studies are needed to study this possibility.