Role for botulinum toxin in back pain treatment in adults with cerebral palsy: report of a case.
OBJECTIVE
To report a case illustrating the usefulness of botulinum toxin A in the treatment of spinal dystonia responsible for low back pain and postural disorders.


METHODS
Critical appraisal of a case report.


METHODS
A young woman with cerebral palsy had lumbar paraspinal muscle dystonia responsible for pain and hyperlordosis unresponsive to oral medications for muscle spasm. Botulinum toxin A (Botox(R), 200 U) was injected into the paraspinal muscles at six sites, to good effect.


CONCLUSIONS
The few reported cases consistently show a favorable effect of local botulinum toxin A injections in patients with painful paraspinal muscle dystonia related to neurological disease or chronic low back pain.


CONCLUSIONS
Botulinum toxin A may be a useful treatment for incapacitating painful dystonia of the paraspinal muscles. This treatment improves posture in the sitting position and facilitates the fitting of orthotic devices. Furthermore, botulinum toxin A treatment may help to determine whether an intrathecal baclofen test is in order.
Gallien
Philippe
P
Service de Médecine Physique et Réadaptation, CHU Pontchaillou, rue Henri le Guillou, 35033 Rennes, France. philippe-gallien@chu-Rennes.fr
Nicolas
Benoît
B
Petrilli
Sabine
S
Kerdoncuff
Valérie
V
Lassalles
Arnaud
A
Le Tallec
Hélène
H
Durufle
Aurélie
A
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D004421:Dystonia / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A