Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this evidence based medicine review is to determine whether or not Botulinum Toxin A is safe and effective for the treatment of trigeminal neuralgia in adults.

STUDY DESIGN: Three double blind, randomized controlled trials were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

DATA SOURCES: Each study was obtained by searching NCBI and PubMed database.

OUTCOMES MEASURED: The outcomes were measured using the Visual Analog Scale (VAS), Quality of Life (QoL), Patient Global Impression of Change Scale (PGIC), Last Observation Carried Forward (LOCF), and detected adverse effects.

RESULTS: The results Shehata et al. study showed that the VAS and LOCF showed significant decrease in daily pain, use of acute medications, daily paroxysms, and increase in QoL using Botulinum Toxin A vs. normal saline. These results were shown by pain had a decrease by 6.5 with Botulinum Toxin A vs. 0.3 with normal saline, paroxysms with a score of 0.88 to 7.12, acute medications with a score of 3.69 to 5.71, and QoL with a score of 8.35 to 9.65, and these all had p values of

CONCLUSIONS: All three RCTs demonstrated positive outcomes with Botulinum Toxin A in the treatment of trigeminal neuralgia with low risk of detected adverse effects.