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Ultrasound-guided injection of the iliopsoas muscle with botulinum toxin in camptocormia.

Abstract
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.
AuthorsRainer von Coelln, Armin Raible, Thomas Gasser, Friedrich Asmus
JournalMovement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 23 Issue 6 Pg. 889-92 (Apr 30 2008) ISSN: 1531-8257 [Electronic] United States
PMID18307265 (Publication Type: Case Reports, Journal Article)
Copyright(c) 2008 Movement Disorder Society.
Chemical References
  • Anti-Dyskinesia Agents
  • Botulinum Toxins
Topics
  • Aged
  • Anti-Dyskinesia Agents (therapeutic use)
  • Botulinum Toxins (therapeutic use)
  • Female
  • Humans
  • Male
  • Parkinson Disease (complications, drug therapy)
  • Psoas Muscles
  • Treatment Outcome

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