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Subcutaneous BTX-A injection can result in relieving pain in intractable cases with TN with minimal adverse reactions and can be an effective treatment option.
Objective: We evaluated the efficacy of intravenous γ-globulin (IVGG) administration for children with Kawasaki disease to establish whether additional, more advanced therapy is needed in intractable cases.
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Invasive operations such as neurovascular decompression [11], gamma knife radiosurgery [12], partial sensory rhizotomy, and percutaneous radiofrequency thermo-coagulation [13] may be required in some intractable cases.
This can reduce the level of pain in otherwise intractable cases.
TCR-γ gene is recommended to the routine analysis, whereas TCR-β gene has potential in combination toward intractable cases.
TPO-RAs are effective in approximately 60% 90% of intractable cases; however, once treatment is discontinued, the platelet count decreases to the pre-treatment level within 2 weeks [ 4- 6].
In-patient treatment under anaesthesia is usually reserved for the most severe or intractable cases of genital warts.
These results indicate that BTX-A has a direct analgesic effect in patients with TN and can represent a therapeutic option for intractable cases.
Others suggest that bursectomy may be necessary for intractable cases; the operation is an outpatient procedure that can be performed in less than half an hour.
Obviously, our results include such intractable cases.
Invasive surgical procedures can be reserved to intractable cases [5].
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