Botulinum Toxin Injection for Pain in Muscle Spasm and Visceromotor Disorders: A Meta-Analytic Study

2017 ◽  
Vol 1 (1) ◽  
pp. 69-78
Author(s):  
Paula Ruth L Siongco ◽  
Mary Camille E Rosales ◽  
Raymond L Rosales
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Muscle Spasm ◽  
Analytic Study

Botulinum Toxin Injection of the Cricopharyngeus Muscle for the Treatment of Dysphagia

2000 ◽  
Vol 122 (5) ◽  
pp. 691-695 ◽  
Author(s):  
Syed F. Ahsan ◽  
Robert J. Meleca ◽  
James Paul Dworkin
Keyword(s):  
Botulinum Toxin ◽  
Rating Scale ◽  
Botulinum Toxin Injection ◽  
Retrospective Chart Review ◽  
Muscle Spasm ◽  
Barium Swallow ◽  
Patient Questionnaire ◽  
Therapeutic Effects ◽  
Swallowing Function ◽  
Botox Injection

OBJECTIVE: This study was conducted to evaluate, subjectively and objectively, the diagnostic and therapeutic effects of botulinum toxin (Botox) in patients with dysphagia caused by cricopharyngeus (CP) muscle spasm and/or hypertonicity. METHODS: A retrospective chart review was done of 5 patients with normally functioning larynges treated with CP Botox injection for dysphagia caused by perceived spasm. Subjective measures of swallowing function after injection were obtained with a patient questionnaire. Objective data were obtained both before and after surgery by one or more of the following tests: modified barium swallow study, manometry, videostroboscopy, and fiberoptic endoscopic evaluation of swallowing. Quality-of-life measures were obtained with a swallowing rating scale. RESULTS: Overall, all patients had initial improvement in swallowing after Botox injection. The duration of benefit was from 2 to 14 months. There were no complications. Four of 5 patients had long-term benefits, as evidenced by decreased or eliminated aspiration symptoms, removal of tracheotomy, ability to eat solid foods, and weight gain. One patient continues to have poor swallowing function. CONCLUSION: Botox injection of the CP muscle to treat dysphagia is effective in patients with underlying muscle spasm or hypertonicity. A positive response to Botox can also help confirm the diagnosis of CP muscle spasm.

scholarly journals Botulinum toxin for chronic pelvic pain in women with endometriosis: a cohort study of a pain-focused treatment

2019 ◽  
Vol 44 (9) ◽  
pp. 886-892 ◽  
Author(s):  
Hannah K Tandon ◽  
Pamela Stratton ◽  
Ninet Sinaii ◽  
Jay Shah ◽  
Barbara I Karp
Keyword(s):  
Botulinum Toxin ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Pelvic Floor Muscle ◽  
Botulinum Toxin Injection ◽  
Case Series ◽  
Pain Medication ◽  
Muscle Spasm ◽  
Open Label ◽  
Topical Anesthetic

Background and objectivesMany women with endometriosis continue to have pelvic pain despite optimal surgical and hormonal treatment; some also have palpable pelvic floor muscle spasm. We describe changes in pain, spasm, and disability after pelvic muscle onabotulinumtoxinA injection in women with endometriosis-associated pelvic pain, a specific population not addressed in prior pelvic pain studies on botulinum toxin.MethodsWe present an open-label proof-of-concept case series of women with surgically diagnosed endometriosis. Under conscious sedation and with topical anesthetic, 100 units of onabotulinumtoxinA was injected transvaginally into pelvic floor muscle spasm areas under electromyography guidance. Changes in pain intensity, muscle spasm, disability, and pain medication use were assessed at periodic visits for up to 1 year after injection.ResultsThirteen women underwent botulinum toxin injection and were followed for at least 4 months. Before injection, 11 of the 13 women had spasm in >4/6 assessed pelvic muscles and reported moderate pain (median visual analog scale (VAS): 5/10; range: 2–7). By 4–8 weeks after injection, spasm was absent/less widespread (≤3 muscles) in all (p=0.0005). Eleven rated their postinjection pain as absent/mild (median VAS: 2; range: 0–5; p<0.0001); 7/13 reduced pain medication. Disability decreased in 6/8 women with at least moderate preinjection disability (p=0.0033). Relief lasted 5–11 months in 7 of the 11 patients followed for up to 1 year. Adverse events were mild and transient.ConclusionsThese findings suggest pelvic floor spasm may be a major contributor to endometriosis-associated pelvic pain. Botulinum toxin injection may provide meaningful relief of pain and associated disability.Trial registration numberNCT01553201

Botulinum toxin injection of the cricopharyngeus muscle for the treatment of dysphagia

2000 ◽  
Vol 122 (5) ◽  
pp. 691-695 ◽  
Author(s):  
Syed F. Ahsan ◽  
Robert J. Meleca ◽  
Paul Dworkin James
Keyword(s):  
Botulinum Toxin ◽  
Rating Scale ◽  
Botulinum Toxin Injection ◽  
Retrospective Chart Review ◽  
Muscle Spasm ◽  
Barium Swallow ◽  
Patient Questionnaire ◽  
Therapeutic Effects ◽  
Swallowing Function ◽  
Botox Injection

OBJECTIVE: This study was conducted to evaluate, subjectively and objectively, the diagnostic and therapeutic effects of botulinum toxin (Botox) in patients with dysphagia caused by cricopharyngeus (CP) muscle spasm and/or hypertonicity. METHODS: A retrospective chart review was done of 5 patients with normally functioning larynges treated with CP Botox injection for dysphagia caused by perceived spasm. Subjective measures of swallowing function after injection were obtained with a patient questionnaire. Objective data were obtained both before and after surgery by one or more of the following tests: modified barium swallow study, manometry, videostroboscopy, and fiberoptic endoscopic evaluation of swallowing. Quality-of-life measures were obtained with a swallowing rating scale. RESULTS: Overall, all patients had initial improvement in swallowing after Botox injection. The duration of benefit was from 2 to 14 months. There were no complications. Four of 5 patients had long-term benefits, as evidenced by decreased or eliminated aspiration symptoms, removal of tracheotomy, ability to eat solid foods, and weight gain. One patient continues to have poor swallowing function. CONCLUSION: Botox injection of the CP muscle to treat dysphagia is effective in patients with underlying muscle spasm or hypertonicity. A positive response to Botox can also help confirm the diagnosis of CP muscle spasm.

Persistent Diplopia in Visually Mature Patients. Is it Intractable or something else? A Review and Case Series

2017 ◽  
pp. 90-108
Keyword(s):  
Botulinum Toxin ◽  
Extraocular Muscle ◽  
Botulinum Toxin Injection ◽  
Case Series ◽  
Sensory Adaptation ◽  
Single Vision ◽  
Injection Treatment ◽  
Vision Therapy ◽  
Extraocular Muscle Surgery

Diplopia is described as being intractable when there is inability to both fuse the two images and suppress the second image. Intractable diplopia persists despite achieving ocular alignment using either prisms, lenses,vision therapy,extraocular muscle surgery, or botulinum toxin injection. Treatment usually resorts to occluding or fogging the patient’s nondominant eye. Often times, however, adults having other causative mechanisms for supposedly persistent diplopia are able to achieve comfortable single vision with treatment that either establishes fusion or reactivates a preexisting sensory adaptation. This case series reviews these other causes of diplopia.

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