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Intramuscular Botulinum Toxin A (BtxA) in Complex Regional Pain Syndrome
Journal article   Open access   Peer reviewed

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

Siddharth Kharkar, Prakash Ambady, Venkatesh Yedatore and Robert Schwartzman
Pain physician, v 14(3), pp 311-316
01 May 2011
PMID: 21587336
url
https://doi.org/10.36076/ppj.2011/14/311View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Anesthesiology Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Science & Technology
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). Ninety-seven 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%)

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Web of Science research areas
Anesthesiology
Clinical Neurology
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