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Botulinum toxin type A for the treatment of equinus deformity in patients with mucopolysaccharidosis type II.

Abstract
Mucopolysaccharidoses are lysosomal storage disorders that are caused by a deficiency in the enzymes that degrade glycosaminoglycans. The accumulation of glycosaminoglycans affects multiple systems, resulting in coarse facial features, short stature, organomegaly, and variable neurological changes from normal intelligence to severe mental retardation and spasticity. Effects on the musculoskeletal system include dysostosis multiplex, joint stiffness, and muscle shortening. This article reports 2 patients with mucopolysaccharidosis type II (Hunter syndrome) who showed progressive equinus deformity of the feet. Both patients were treated with intramuscular botulinum toxin type A injections in the gastrocnemius and the soleus muscles, followed by serial casting. In both patients, passive range of motion, muscle tone, and gait performance were significantly improved. Botulinum toxin type A injections followed by serial casting are a therapeutic option for contractures in patients with mucopolysaccharidosis. However, the long-term effects and the effect of application in other muscles remain unknown.
AuthorsEsmeralda Nava, Peter Weber, Matthias Gautschi, Jean-Marc Nuoffer, Sebastian Grunt
JournalJournal of child neurology (J Child Neurol) Vol. 27 Issue 12 Pg. 1611-5 (Dec 2012) ISSN: 1708-8283 [Electronic] United States
PMID22433425 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Neuromuscular Agents
  • Botulinum Toxins, Type A
Topics
  • Botulinum Toxins, Type A (therapeutic use)
  • Child, Preschool
  • Equinus Deformity (drug therapy, etiology)
  • Humans
  • Infant
  • Male
  • Mucopolysaccharidosis II (complications)
  • Neuromuscular Agents (therapeutic use)

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