Pain Management

Dominique Batifol has completed her PhD and Profersor University Hospital of Montpellier, France. She is currently working in the Maxillo-Facial SurgeryDepartment in the University Hospital of Montpellier. She has published 15 papers in reputed journals, has written a book in french  “injections in temporo-mandibular disorders’’ (EUE) and has presented 2 books in the english language.

To describe the treatment by botulinum toxin type A (BoNTA) for seven painful pathologies of head and neck: cervical neuralgia, trigeminal neuralgia, migraine headache, articular pain, hypertrophic scars pain and inflammation, postoperative muscular pain of the cervical spine and muscle pain due to stiffness of the cervical spine following hypertonia and hyperactivity of the manducatory muscles. BoNTA has been used for forty years by its action on muscles. During the last decade new indications have been added, following the proof of the effect of the BT on numerous neurotransmitters. Technically, we inject into the muscles to relax them, into the keloid scars or immediately around to stop the inflammation, to relieve pain, we simply follow it, by topping of the skin, the scalp or the oral mucosa, depending on the pathology and the painful zone. For the temporo-mandibular joint, the injection is directly placed in the articulation. The toxin is very efficient on paroxysmal pain and for all these indications, we note a real decrease of the VAS (Visual Analogue Scale) score. For some indications, the dosage can be high, but there are no side effects or very limited. Except migraine headache, the other indications are new and there are not so many teams doing it.