Effect of Botulinum Toxin on Disabling Neuropathic Pain: A Case Presentation Suggesting a New Therapeutic Strategy

This case presentation describes a 47‐year‐old woman who developed complex regional pain syndrome type II with severe neuropathic pain following iatrogenic transection of the tibial nerve at the ankle. The pain and disability progressively worsened over time, markedly impaired ambulation, and were n...

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Bibliographic Details
Published in:PM & R 2017-02, Vol.9 (2), p.200-203
Main Authors: Buonocore, Michelangelo, Demartini, Laura, Mandrini, Silvia, Dall'Angelo, Anna, Dalla Toffola, Elena
Format: Article
Language:English
Subjects:
Acetylcholine Release Inhibitors - therapeutic use
Ankle Joint - innervation
Botulinum Toxins, Type A - therapeutic use
Female
Humans
Iatrogenic Disease
Middle Aged
Neuralgia - drug therapy
Pain Management - methods
Pain Measurement
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Summary:This case presentation describes a 47‐year‐old woman who developed complex regional pain syndrome type II with severe neuropathic pain following iatrogenic transection of the tibial nerve at the ankle. The pain and disability progressively worsened over time, markedly impaired ambulation, and were not relieved despite various analgesic treatments. After injection of botulinum toxin (abobotulinumtoxinA, BoNT‐A) in the leg muscles the tendons of which pass through the tarsal tunnel (together with the tibial nerve), her pain decreased and her walking capacity improved. This case suggests a new therapeutic role for botulin toxin in treating peripheral neuropathic pain caused by movement‐evoked ectopic potentials. Level of Evidence V
ISSN:1934-1482
1934-1563
DOI:10.1016/j.pmrj.2016.10.014