Lee Sung Young, Lee Hyeok Dong, Cho Young-Shin, Han Seung Hoon
Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2018 Oct;97(42):e12785. doi: 10.1097/MD.0000000000012785.
Botulinum toxin A (BTX-A) injection is effective in treating focal dystonia. However, there are no prior reports regarding the treatment of progressive focal dystonia by a single BTX-A injection that affect a distant muscle.
A 19-year-old male was referred to the rehabilitation clinic with a complaint of involuntary movement in his left big toe. The involuntary movement pattern was initially observed in the abduction direction only; however, it progressed to irregular mixed patterns in the flexion and abduction directions.
In needle electromyography, abnormal dystonic patterns were observed in the left abductor hallucis (AH), flexor hallucis longus, and flexor hallucis brevis muscles.
These symptoms resolved with a single BTX-A injection to the AH muscle.
In this case, a single BTX-A injection to 1 muscle for treating progressive focal dystonia was effective on a distant noninjected muscle.
A型肉毒毒素(BTX-A)注射在治疗局灶性肌张力障碍方面有效。然而,此前尚无关于单次BTX-A注射治疗影响远处肌肉的进行性局灶性肌张力障碍的报道。
一名19岁男性因左大脚趾不自主运动而被转诊至康复诊所。不自主运动模式最初仅在外展方向观察到;然而,它发展为屈曲和外展方向的不规则混合模式。
在针极肌电图检查中,在左拇展肌(AH)、拇长屈肌和拇短屈肌中观察到异常的肌张力障碍模式。
对AH肌肉进行单次BTX-A注射后,这些症状得到缓解。
在本病例中,对一块肌肉进行单次BTX-A注射以治疗进行性局灶性肌张力障碍,对远处未注射的肌肉有效。