title: Intradermal botulinum toxin type A injection effectively reduces residual limb hyperhidrosis in amputees: a case series.
abstract: OBJECTIVE
  To study the effectiveness of botulinum toxin type A (BTX-A) therapy for residual limb hyperhidrosis, prosthesis fit and function, and residual and phantom limb pain in patients with limb amputation.
  
  
  METHODS
  Consecutive case series.
  
  
  METHODS
  Outpatient physical medicine and rehabilitation clinic.
  
  
  METHODS
  Walter Reed Army Medical Center patients (N=8) with unilateral traumatic upper- or lower-limb amputation.
  
  
  METHODS
  BTX-A was injected transdermally in a circumferential pattern around the residual limb by using a 1-cm matrix grid.
  
  
  METHODS
  A 10-cm continuous Likert visual analog scale was used to assess residual limb sweating and pain and prosthesis fit and function before and 3 weeks after BTX-A injections.
  
  
  RESULTS
  Patients reported a significant reduction in sweating and improvement in prosthesis fit and function after treatment. However, residual limb and phantom pain were unaffected by treatment.
  
  
  CONCLUSIONS
  BTX-A may be an effective treatment for residual limb hyperhidrosis, resulting in subjective improvement in prosthesis fit and functioning. BTX-A should be considered as a method to manage excessive sweating in the residual limb of traumatic amputees.
authors.affiliation: Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Charrow
authors.forename: Marc
authors.initials: M
authors.lastname: DiFazio
authors.forename: Leslie
authors.initials: L
authors.lastname: Foster
authors.forename: Paul F
authors.initials: PF
authors.lastname: Pasquina
authors.forename: Jack W
authors.initials: JW
authors.lastname: Tsao
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects; D000672:Amputation Stumps; D000674:Amputees / Q000534:rehabilitation; D001132:Arm / Q000601:surgery; D001186:Artificial Limbs; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy* / Q000209:etiology; D007271:Injections, Intradermal; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D010591:Phantom Limb / Q000188:drug therapy* / Q000209:etiology; D017755:Prosthesis Fitting
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A