HEALTH

By ERIC NAGOURNEY

Published: November 1, 2005

Botox may do more than just get rid of wrinkles.

In addition to providing relief from eye spasms and migraines, Botox, formally botulinum toxin A, has now been found useful in treating the intense facial pain called trigeminal neuralgia. In a study published in the Oct. 25 issue of Neurology, the drug provided partial or complete relief to all 13 patients tested.

Until now, anticonvulsant drugs or neurosurgery have been the only treatments for the disorder. The drugs can have unpleasant side effects, and the surgery is expensive and carries risks. Neither treatment is universally effective.

Dr. Stephen D. Silberstein, a co-author on the paper, said he would recommend Botox even though it had not been randomly tested in controlled clinical trials.

"The purists would say you shouldn't do something not proven in a double-blind study," Dr. Silberstein said, referring to research in which one group is given the medicine and another group is given a placebo. "But the surgical alternatives are unproven procedures that are more expensive and more risky. I don't see any reason not to use it just because we don't have all the evidence in."

The Botox treatment requires injections of 10 units four or five times a year. Botox costs about $5 a unit, according to Dr. Silberstein, who is a professor of neurology at Jefferson Medical College in Philadelphia.

Most patients in the 60-day study reduced their consumption of pain medication by 50 percent; some stopped it completely. While acknowledging that the study was small and not a randomized trial, Dr. Silberstein says the treatment is safe and effective. "I don't see any downside risk of Botox," he said.

"The only side effects are not from the drug," he added, "but from using it improperly."

Updated 11-2-05