scholarly journals Intramuscular Botulinum Toxin A (BtxA) in Complex Regional Pain Syndrome

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. 311-316
Author(s):  
Robert Schwartzman
Keyword(s):  
Botulinum Toxin ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Botulinum Toxin A ◽  
Case Series ◽  
Pain Syndrome ◽  
Control Group ◽  
Retrospective Case ◽  
Toxin A

Background: Pain associated with complex regional pain syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described. Objectives: To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment. Study Design: Retrospective chart review. Setting: Outpatient clinic. Methods: Patients: 37 patients with spasm/dystonia in the neck and/or upper limb girdle muscles. Intervention: Electromyography-guided injection of botulinum toxin A (BtxA), 10-20 U per muscle. Total dose used was 100 U in each patient. Measurement: Local pain score on an 11 point Likert scale, 4 weeks after BtxA injections. Results: Mean pain score decreased by 43% (8.2 ± 0.8 to 4.5 ± 1.1, P < 0.001). Ninetyseven percent of the patients had significant pain relief. One patient had transient neck drop after the injections. Limitations: This is a retrospective study; it lacks a control group and therefore the placebo effect cannot be eliminated. This study does not provide information on the efficacy of this treatment after 4 weeks. Conclusion(s): Intramuscular injection of botulinum toxin A in the upper limb girdle muscles was beneficial for short term relief of pain caused by CRPS in this retrospective case series. The incidence of complications was low (2.7%) Key words: Complex regional pain syndrome, botulinum toxin, spasm, dystonia

scholarly journals Intramuscular Botulinum Toxin in Complex Regional Pain Syndrome: Case Series and Literature Review

2011 ◽  
Vol 5;14 (5;9) ◽  
pp. 419-424
Author(s):  
Robert Schwartzman
Keyword(s):  
Botulinum Toxin ◽  
Pain Score ◽  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Botulinum Toxin A ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pain Syndrome ◽  
Control Group ◽  
Institutional Review

Background: Pain associated with Complex Regional Pain Syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described. Objectives: To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment. Study Design: Retrospective chart review. Setting: Outpatient clinic. Methods: Thirty-seven patients with spasm/dystonia in the neck and/or upper limb girdle muscles. Intervention: EMG-guided injection of Botulinum toxin - A (BtxA), 10-20 units per muscle. Total dose used was 100 units in each patient. Local pain score was measured on an 11-point Likert scale, 4 weeks after BtxA injections. Results: Mean pain score decreased by 43% (8.2 ± 0.8 to 4.5 ± 1.1, P < 0.001). 97% of patients had significant pain relief. One patient had transient neck drop after the injections. Limitations: This is a retrospective study. It lacks a control group and so the placebo effect cannot be eliminated. This study does not provide information on the efficacy of this treatment after 4 weeks. Conclusions: Intramuscular injection of botulinum toxin in the upper limb girdle muscles was beneficial for short term relief of pain caused by CRPS. The incidence of complications was low (2.7%) Institutional Review: This study was approved by the Institutional Review Board of the Drexel College of Medicine. Key words: Complex regional pain syndrome, botulinum toxin, spasm, dystonia

scholarly journals Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Goal Attainment ◽  
Botulinum Toxin A ◽  
Chronic Stroke ◽  
Mean Difference ◽  
Control Group ◽  
Toxin A ◽  
Upper Limb Rehabilitation ◽  
Experimental Group

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.

scholarly journals Botulinum Toxin A for Treatment of Allodynia of Complex Regional Pain Syndrome: A Pilot Study

Pain Medicine ◽  
2010 ◽  
Vol 11 (9) ◽  
pp. 1411-1414 ◽  
Author(s):  
Delaram Safarpour ◽  
Arash Salardini ◽  
Diana Richardson ◽  
Bahman Jabbari
Keyword(s):  
Botulinum Toxin ◽  
Pilot Study ◽  
Complex Regional Pain Syndrome ◽  
Botulinum Toxin A ◽  
Pain Syndrome ◽  
Toxin A

Subcutaneous Botulinum Toxin A for the Treatment of Refractory Complex Regional Pain Syndrome

PM&R ◽  
2012 ◽  
Vol 4 (6) ◽  
pp. 446-449 ◽  
Author(s):  
Pravardhan Birthi ◽  
Paul Sloan ◽  
Sara Salles
Keyword(s):  
Botulinum Toxin ◽  
Complex Regional Pain Syndrome ◽  
Botulinum Toxin A ◽  
Pain Syndrome ◽  
Toxin A
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