title: Treatment of Raynaud's phenomenon with botulinum toxin type A.
abstract: Raynaud's phenomenon (RP), an episodic vasospasm of the peripheral arteries, is quite common in general population. The current therapies of RP are limited by efficacy, side effects, and polypharmacy concerns. Botulinum toxin type A (BTX-A) local injections have been reported for the treatment of RP, but the injection sites, concentration and dose of BTX-A were different from each other in previous trials. In addition, so far, there have been no reports concerning local injection of BTX-A in Asian RP patients. Ten patients with RP in China were included in this retrospective study. All the patients had intractable pain and were non-responsive to conservative and/or medical therapy. A patterned BTX-A injection was performed in RP patients, guided by ultrasonography. BTX-A was injected as 20 u/ml devoid of preservatives. Outcomes were measured by ultrasonography, surface temperature, visual analog scale (VAS) for clinical symptoms (pain, numbness, stiffness and swelling), and changes in ulcers or gangrene. Overall, a great improvement in artery flow velocity (P < 0.01), surface temperature (P < 0.01), ulcer and VAS for clinical symptoms, was observed after BTX-A local injection. Complications were very rarely found, and no patients complained of hand weakness and bruise. BTX-A patterned injection guided by ultrasonography might be a useful therapeutic tool in the management of intractable RP.
authors.affiliation: Department of Neurology, Shanghai Tongji Hospital, Tongji University School of Medicine, Xin-Cun Road 389, Shanghai, 200065, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Nie
authors.forename: Ye
authors.initials: Y
authors.lastname: Song
authors.forename: Yougui
authors.initials: Y
authors.lastname: Pan
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Lingjing
authors.initials: L
authors.lastname: Jin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature / Q000187:drug effects; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011928:Raynaud Disease / Q000188:drug therapy*; D012189:Retrospective Studies; D014456:Ulcer / Q000188:drug therapy / Q000209:etiology; D014463:Ultrasonography; D064232:Visual Analog Scale
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A