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Ultrasound‐guided injection of the iliopsoas muscle with botulinum toxin in camptocormia
Author(s) -
von Coelln Rainer,
Raible Armin,
Gasser Thomas,
Asmus Friedrich
Publication year - 2008
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21967
Subject(s) - medicine , iliopsoas , supine position , botulinum toxin , iliopsoas muscle , parkinsonism , weakness , psoas muscles , trunk , ultrasound , physical medicine and rehabilitation , physical therapy , surgery , radiology , ecology , disease , abscess , biology
Camptocormia is characterized by an abnormal posture of the trunk with pronounced flexion of the thoraco‐lumbar spine during standing and walking, which abates in a supine position. Treatment options for camptocormia are limited and mostly futile. Here, we report on the ultrasound‐guided ventral injection of botulinum toxin A (BTX) into deep portions of the iliopsoas muscle in four parkinsonian patients with camptocormia as chief complaint. Using this novel and safe application technique, all patients received 500–1,500 MU of BTX per side in 4–6 month intervals. Treatment was generally well tolerated. At the highest dose, all patients complained of mild weakness of hip flexion. Standardized physical exam at follow‐up visits, as well as self‐assessment of patients, failed to show a relevant and lasting improvement of posture. In conclusion, injection of BTX into the iliopsoas does not appear to be a promising approach for the treatment of parkinsonism‐associated camptocormia. © 2008 Movement Disorder Society