Botulinum toxin A for treating muscular contractures in cephalic tetanus.
OBJECTIVE
This study reports the use of botulinum toxin for treatment of muscle contractures in a patient with cephalic tetanus.


METHODS
Case report.


RESULTS
An 80-year-old woman was diagnosed with cephalic tetanus, with contractures of the masseter, sternocleidomastoid, trapezius, and levator scapulae muscles. After one month of conventional treatment good recovery was observed, but with persistence of the contractures of the sternocleidomastoid, trapezius and levator scapulae. These contractures were treated with botulinum toxin A (75IU in the right sternocleidomastoid, 25IU in the right trapezius; one month later 50IU in the left levator scapulae, 50IU in the right levator scapulae, 75IU in the left sternocleidomastoid; two months later 25IU in the left trapezius). Full recovery was observed.


CONCLUSIONS
Local infiltration with botulinum toxin A appears to be an effective treatment for persistent muscle contracture in cephalic tetanus.
García-García
Abel
A
Facultad de Medicina y Odontología, University of Santiago de Compostela, Santiago de Compostela, Spain. ciabelgg@usc.es
Gándara-Rey
José M
JM
Crespo-Abelleira
Antonio
A
Jorge-Barreiro
Javier
J
D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008410:Masticatory Muscles / Q000187:drug effects; D009334:Neck Muscles / Q000187:drug effects; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care; D012782:Shoulder; D013742:Tetanus / Q000188:drug therapy*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A