Two years ago, a good friend brought her father to see me about terrible facial pain called trigeminal neuralgia. The pain had been unresponsive to all medications, and he was so miserable that he could not leave his house and had lost interest in everything that used to give him pleasure. He had been advised to have experimental neurosurgery, which he had rejected. He was desperate to do anything.

My friend had read about treating trigeminal neuralgia with botulinum toxin. I looked it up and there were a few scattered reports—no one had treated more than a handful of patients. There is no currently explainable
reason why botulinum toxin should work in this disease.

After telling the patient all of this, and advising him that the worst botulinum toxin could do was not work, I gave him a few small injections in low doses. In two days the pain was 90% gone. I re-treated him in a month. He has been pain free for two years without any other medications and without further injections. His life has begun again.

I cannot explain it, but this cannot be a placebo effect. I have treated a small number of other patients with similar results—almost complete relief after one injection. If these results hold, the treatment will be a huge help in a debilitating disease. Further work is underway.