Ultrasound-Guided Injection of the Iliopsoas Muscle with Botulinum Toxin in Camptocormia
Identifieur interne : 001030 ( PascalFrancis/Checkpoint ); précédent : 001029; suivant : 001031Ultrasound-Guided Injection of the Iliopsoas Muscle with Botulinum Toxin in Camptocormia
Auteurs : Rainer Von Coelln [Allemagne] ; Armin Raible [Allemagne] ; Thomas Gasser [Allemagne] ; Friedrich Asmus [Allemagne]Source :
- Movement disorders [ 0885-3185 ] ; 2008.
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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.
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i1="02"><s1>Department of Internal Medicine I, University of Tuebingen</s1><s2>Tuebingen</s2><s3>DEU</s3><sZ>2 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Gasser, Thomas" sort="Gasser, Thomas" uniqKey="Gasser T" first="Thomas" last="Gasser">Thomas Gasser</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen</s1><s2>Tuebingen</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement 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Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author><author><name sortKey="Asmus, Friedrich" sort="Asmus, Friedrich" uniqKey="Asmus F" first="Friedrich" last="Asmus">Friedrich Asmus</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen</s1><s2>Tuebingen</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Tübingen</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bontoxilysin</term><term>Dorsal spine</term><term>Guidance</term><term>Iliopsoas muscle</term><term>Kyphosis</term><term>Nervous system diseases</term><term>Ultrasound</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cyphose</term><term>Pathologie du système nerveux</term><term>Ultrason</term><term>Muscle psoas iliaque</term><term>Bontoxilysin</term><term>Guidage</term><term>Rachis dorsal</term><term>Camptocormie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Ultrasound-Guided Injection of the Iliopsoas Muscle with Botulinum Toxin in Camptocormia</s1></fA08><fA11 i1="01" i2="1"><s1>VON COELLN (Rainer)</s1></fA11><fA11 i1="02" i2="1"><s1>RAIBLE (Armin)</s1></fA11><fA11 i1="03" i2="1"><s1>GASSER (Thomas)</s1></fA11><fA11 i1="04" i2="1"><s1>ASMUS (Friedrich)</s1></fA11><fA14 i1="01"><s1>Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen</s1><s2>Tuebingen</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Internal Medicine I, University of Tuebingen</s1><s2>Tuebingen</s2><s3>DEU</s3><sZ>2 aut.</sZ></fA14><fA20><s1>889-892</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000195888140190</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. 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