Hahnemann University Hospital, Philadelphia, PA , USA.
Pain Physician. 2011 May-Jun;14(3):311-6.
Pain associated with complex regional pain syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described.
To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment.
Retrospective chart review.
Outpatient clinic.
37 patients with spasm/dystonia in the neck and/or upper limb girdle muscles.
Electromyography-guided injection of botulinum toxin A (BtxA), 10-20 U per muscle. Total dose used was 100 U in each patient.
Local pain score on an 11 point Likert scale, 4 weeks after BtxA injections.
Mean pain score decreased by 43% (8.2 ± 0.8 to 4.5 ± 1.1, P < 0.001). Ninety-seven percent of the patients had significant pain relief. One patient had transient neck drop after the injections.
This is a retrospective study; it lacks a control group and therefore the placebo effect cannot be eliminated. This study does not provide information on the efficacy of this treatment after 4 weeks.
CONCLUSION(S): Intramuscular injection of botulinum toxin A in the upper limb girdle muscles was beneficial for short term relief of pain caused by CRPS in this retrospective case series. The incidence of complications was low (2.7%).
与复杂性区域疼痛综合征（CRPS）相关的疼痛通常非常剧烈且难以缓解。肉毒毒素用于缓解 CRPS 相关疼痛的应用尚未得到充分描述。
评估肌肉内注射肉毒毒素是否能缓解 CRPS 引起的疼痛，并评估这种治疗方法的风险。
回顾性病历审查。
门诊诊所。
37 例颈部和/或上肢带肌肉痉挛/张力障碍患者。
肌电图引导下注射肉毒毒素 A（BtxA），每个肌肉 10-20U。每位患者的总剂量为 100U。
BtxA 注射后 4 周时的局部疼痛评分，采用 11 点 Likert 量表。
平均疼痛评分下降 43%（8.2±0.8 至 4.5±1.1，P＜0.001）。97%的患者疼痛明显缓解。1 例患者注射后出现短暂性颈部下垂。
这是一项回顾性研究；它缺乏对照组，因此无法消除安慰剂效应。本研究未提供 4 周后该治疗效果的信息。
上肢带肌肉内注射肉毒毒素 A 对缓解该回顾性病例系列中 CRPS 引起的短期疼痛有益。并发症发生率低（2.7%）。
