Neuropathic pruritus is a form of chronic itch that occurs in the presence of direct damage to the nervous system. It tends to be severe, disabling, and difficult to treat. Usual antipruritic medications are largely ineffective and there is no consensus regarding the treatment approach. The authors report a case of a 58-year-old man with primary progressive multiple sclerosis and a history of unsatisfactory management of severe bilateral focal pruritus. Significant symptom relief was attained after local intradermal injections of botulinum toxin type A.
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