Open AccessThe use of botulinum toxin and epidural analgesia for the treatment of spasticity and pain in a patient with maple syrup urine disease
Author(s) -
Abdullah M. Kaki,
Abeer A. Arab
Publication year - 2012
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/1658-354x.97035
Subject(s) - medicine , maple syrup urine disease , spasticity , botulinum toxin , anesthesia , surgery , rehabilitation , physical therapy , biochemistry , chemistry , leucine , amino acid
A 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUD). He suffered from spasticity of the lower limbs and pain that did not respond to oral medications. Injections of botulinum toxin A (BTX-A) at 10 sites and epidural analgesia with 0.125% bupivacaine were used to treat spasticity with good results. We conclude that BTX-A combined with epidural analgesia may be a useful treatment option for incapacitating, painful spasticity related to MSUD. This treatment modality allowed a comprehensive rehabilitation program to be completed and it lasted longer than 9 months.