Document Detail

Botulinum toxin type B in the treatment of residual limb hyperhidrosis for lower limb amputees: a pilot study.
MedLine Citation:
PMID:  21765248     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Botulinum toxin type A is established in the treatment of hyperhidrosis. This pilot study was designed to prove the alleviating effect of botulinum toxin type B (BTX-B) in sweating of the residual limb, as BTX-B, even in low doses, is supposed to possess a more specific action in sympathetic nerves than botulinum toxin type A does at a wider radius of diffusion.
DESIGN: Nine lower limb amputees received 1750 U BTX-B injected at the site of maximum sweating. Before injections and 4 wks and 3 mos after, patients rated their impairments regarding sweating of the residual limb, steadiness of gait, use of the prosthetic device, quality-of-life, work performance, quality of sleep, and skin problems using a numeric rating scale (NRS; 0-10).
RESULTS: Sweating of the residual limb before BTX-B application was rated a median of 7 (interquartile range, 6-10) on the NRS, with significant improvements after 4 wks (NRS, 3 [2-4]; P = 0.027) and 3 mos (NRS, 3 [1-4]; P = 0.020). Impaired quality of artificial limb use likewise improved from a baseline NRS of 9 (5-9) to 2 (1-4) after 4 wks and 3 (1-4) (P = 0.027) after 3 mos, consistent with limited duration of use (P = 0.023). Steadiness of gait, quality-of-life, and work performance increased accordingly, and skin problems decreased clearly but not significantly. Unexpectedly, stump pain was also reduced (baseline: NRS, 5 [4-8]; 4 wks: NRS, 4 [3-5], P = 0.109; 3 mos: NRS, 3 [2-4], P = 0.008).
CONCLUSIONS: Low-dose BTX-B significantly reduced sweating of the residual limb, thereby improving the use of the artificial limb, steadiness of gait, and quality-of-life. Because this has a tremendous impact on amputees, we are in dire need for systematic, larger studies.
Uwe Kern; Matthias Kohl; Ulrich Seifert; Tanja Schlereth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  90     ISSN:  1537-7385     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-07-18     Completed Date:  2011-10-24     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  321-9     Citation Subset:  AIM; IM    
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MeSH Terms
Amputation Stumps*
Artificial Limbs
Botulinum Toxins / therapeutic use*
Cohort Studies
Hyperhidrosis / etiology,  prevention & control*
Injections, Subcutaneous
Lower Extremity*
Middle Aged
Pilot Projects
Quality of Life
Treatment Outcome
Reg. No./Substance:
0Y70779M1F/rimabotulinumtoxinB; EC Toxins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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