Open AccessTreatment of Phantom Limb Pain with Botulinum Toxin Type A
Author(s) -
Kollewe Katja,
Jin Lingjing,
Krampfl Klaus,
Dengler Reinhard,
Mohammadi Bahram
Publication year - 2009
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2008.00554.x
Subject(s) - phantom limb pain , medicine , phantom limb , phantom pain , botulinum toxin , imaging phantom , physical medicine and rehabilitation , anesthesia , surgery , radiology , amputation
. Phantom limb pain and sensations are common in amputees. The pathophysiology remains unclear and the treatment difficult and often unsuccessful. Opioids are frequently used when non‐narcotics have failed, but are not effective in many cases. We report on three phantom and stump pain patients, refractive to previous treatments, who were successfully treated with botulinum toxin A (BoNT‐A). Methods. Three patients who had previously undergone amputation of their leg due to accident (N = 2) or injury by a landmine (N = 1) were treated with BoNT‐A (Dysport ® ). We injected a total dose of up to 500 units (U) BoNT‐A under EMG‐control. Global clinical improvement was based on a 0–3 scale (0 = no effect; 3 = marked improvement) and on a questionnaire rating pain intensity (based on the visual analog scale), intake of pain medication and phantom limb sensations. Results. All three patients evaluated the clinical global improvement with 3 (marked improvement). The pain intensity and pain medication was reduced significantly in all three cases. No side effects were reported. The duration of response lasted up to 11 weeks. Discussion. These three successfully treated phantom and stump pain patients show that therapy with BoNT‐A may be worth studying as an effective and safe treatment option for this kind of pain.