Wu S, et al. - Given the inefficacy of Botulinum Toxin Type A (BTX-A) treatment in approximately 10–43% of trigeminal neuralgia (TN) patients, researchers sought for factors that are correlated with the therapeutic effect in BTX-A treatment of medically refractory, classical TN. A total of 104 patients who were receiving BTX-A injection for medically refractory classical TN retrospectively studied for a VAS score, pain attack frequency per day as well as for their overall response to treatment and side effects. Successful results were reported in 87 patients; 41 stated that their pain was completely controlled while 46 reported adequate pain relief, totaling 83.7%. Patients 50 or older showed higher treatment success. Mild side effects were reported in 17 patients (16.3%). These findings suggest that for classical TN, a local injection of BTX-A may be a safe and efficient treatment which persists for several months. BTX-A is a novel strategy which they particularly support for managing middle-aged and elderly patients who cannot endure drug side effects and may be scared of serious complications from microvascular decompression.