Penchev Plamen, Dobrev Valentin, Petrov Petar-Preslav, Hyusein Remzi, Velchev Vladislav, Georgiev Kristiyan
Faculty of Medicine, Medical University of Plovdiv, Plovdiv, BGR.
Department of Neurology, Medical Center "VIP", Targovishte, BGR.
Cureus. 2024 Mar 31;16(3):e57327. doi: 10.7759/cureus.57327. eCollection 2024 Mar.
Raynaud's syndrome is characterized by paroxysmal vasospasm in the digital arterioles, following exposure to cold or stress. Pain, swelling, stiffness, and hypoesthesia are observed as manifestations. The presence of a trophic ulcer is accompanied by a range of severe manifestations. The assaults occur in three distinct phases, namely vasospastic, plethoric, and erythema. Various approaches improve the overall well-being of a patient. It is possible to differentiate between primary and secondary Raynaud's syndrome, the latter being linked to systemic diseases. The application of botulin toxin is commonly indicated in several medical conditions including focal dystonia, spasticity with or without contractures, paraparesis in children with cerebral palsy, multiple sclerosis, brain injuries, involuntary muscle hyperactivity of a non-dystonic nature, pain management, strabismus, nystagmus, sialorrhea, and esthetic medicine. When treating Raynaud's a technique is used with injection at the base of each finger, from the palmar side, which helps with cooling and minimizing discomfort for patients. We present a clinical case of a 70-year-old female patient with Raynaud's syndrome in which we have placed 70E distributed to both hands botulin toxin type A. Improvement in the patient's symptomatology was noticed on day 3, with warming of the hands, lack of swelling, and pain with duration of the effect little over three months. The patient underwent a six-month follow-up following the therapy with botulinum toxin type A, and no indications of recurrence or advancement of Raynaud's syndrome (RS) were seen.
雷诺综合征的特征是在接触寒冷或压力后，手指小动脉出现阵发性血管痉挛。疼痛、肿胀、僵硬和感觉减退是其表现。营养性溃疡的出现伴有一系列严重表现。发作分为三个不同阶段，即血管痉挛期、充血期和红斑期。多种方法可改善患者的整体健康状况。原发性和继发性雷诺综合征可以区分，后者与全身性疾病有关。肉毒毒素在多种医疗状况中普遍适用，包括局限性肌张力障碍、伴有或不伴有挛缩的痉挛、脑瘫儿童的截瘫、多发性硬化症、脑损伤、非肌张力障碍性的不自主肌肉活动亢进、疼痛管理、斜视、眼球震颤、流涎以及美容医学。治疗雷诺综合征时，采用从手掌侧在每个手指根部注射的技术，这有助于患者手部保暖并减轻不适。我们呈现了一例70岁女性雷诺综合征患者的临床病例，我们向其双手注射了70E单位的A型肉毒毒素。在第3天观察到患者症状有所改善，手部变暖，肿胀消失，疼痛缓解，效果持续略超过三个月。患者在接受A型肉毒毒素治疗后进行了为期六个月的随访，未发现雷诺综合征复发或进展的迹象。
