Document Detail

Botulinum toxin type A in the healing of a chronic buttock ulcer in a patient with spastic paraplegia after spinal cord injury.
MedLine Citation:
PMID:  19894009     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pressure sores are a significant secondary complication in spinal cord injured patients. A new indication for botulinum toxin type A is described here, in treatment of recurrent muscular spasms that had hampered the healing of a chronic buttock ulcer in a subject with severe spastic paraplegia.
CASE REPORT: A 27-year-old man with spastic paraplegia following traumatic spinal cord lesion at the thoracic level had developed recurrent severe muscular spasms, particularly involving the buttock region, with an Ashworth scale score of 3-4 and a Spasm Frequency Scale of grade 4. The patient had a pressure ulcer in the left gluteal region (grade IV according to the European Pressure Ulcer Advisory Panel (EPUAP). Several treatments were administered without success, and all efforts at healing the ulcer by topical medication were hampered by recurrent spasms involving the buttock muscles and ulcer region. The left gluteus maximus muscle was treated with 2 infiltrations of 660 IU botulinum toxin type A. The use of botulinum toxin type A allowed better care of the pressure ulcer, which had healed by 6 months after the initial infiltration.
CONCLUSION: The use of botulinum toxin type A may be an important adjunctive therapy for treatment of pathological conditions involving recalcitrant involuntary muscle contraction.
Domenico Intiso; Mario Basciani
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of rehabilitation medicine     Volume:  41     ISSN:  1651-2081     ISO Abbreviation:  J Rehabil Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-06     Completed Date:  2009-11-12     Revised Date:  2014-05-30    
Medline Journal Info:
Nlm Unique ID:  101088169     Medline TA:  J Rehabil Med     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  1100-2     Citation Subset:  IM    
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MeSH Terms
Botulinum Toxins, Type A / therapeutic use*
Chronic Disease
Muscle Spasticity / complications,  drug therapy*,  etiology
Neuromuscular Agents / therapeutic use*
Paraplegia / complications*
Pressure Ulcer / drug therapy*
Spinal Cord Injuries / complications*
Wound Healing / drug effects
Reg. No./Substance:
0/Neuromuscular Agents; EC Toxins, Type A

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

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