Role for botulinum toxin in back pain treatment in adults with cerebral palsy: report of a case

• Published in: Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2004, Vol.71 (1), p.76-78
• Main Authors: Gallien, Philippe, Nicolas, Benoît, Petrilli, Sabine, Kerdoncuff, Valérie, Lassalles, Arnaud, Le Tallec, Hélène, Durufle, Aurélie
• Format: Article
• Language: English
• Subjects: Adult; Botulinum toxin A; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - therapeutic use; Cerebral palsy; Cerebral Palsy - complications; Cerebral Palsy - physiopathology; Dystonia; Dystonia - complications; Dystonia - physiopathology; Female; Humans; Injections, Intramuscular; Low back pain; Low Back Pain - drug therapy; Low Back Pain - etiology; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - therapeutic use
• ISSN: 1297-319X
• DOI: 10.1016/S1297-319X(03)00124-6

Objective. – To report a case illustrating the usefulness of botulinum toxin A in the treatment of spinal dystonia responsible for low back pain and postural disorders. Methods. – Critical appraisal of a case report. Case report. – A young woman with cerebral palsy had lumbar paraspinal muscle dystonia responsible for pain and hyperlordosis unresponsive to oral medications for muscle spasm. Botulinum toxin A (Botox®, 200 U) was injected into the paraspinal muscles at six sites, to good effect. Discussion. – The few reported cases consistently show a favorable effect of local botulinum toxin A injections in patients with painful paraspinal muscle dystonia related to neurological disease or chronic low back pain. Conclusion. – Botulinum toxin A may be a useful treatment for incapacitating painful dystonia of the paraspinal muscles. This treatment improves posture in the sitting position and facilitates the fitting of orthotic devices. Furthermore, botulinum toxin A treatment may help to determine whether an intrathecal baclofen test is in order.