好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Improvement in Camptocormia Following Botulinum Toxin Injection to the External Oblique Muscle
Movement Disorders
P06 - (-)
105
BACKGROUND: Camptocormia is an abnormal forward flexion of the thoracolumbar spine that increases when standing or walking and abates or disappears in the recumbent position. The RA muscles are most commonly injected with BTX for treatment of dystonic camptocormia.
DESIGN/METHODS: A 66 year old woman with Parkinson's disease(PD) for 7 years presented with camptocormia for two years with painful abdominal contractions. She had a past left Transverse Rectus Abdominis Myocutaneous (TRAM) flap procedure for breast reconstruction. Baseline examination was remarkable for scoliosis and 45-degree forward flexion of the spine and MDS-UPDRS of 64. There were palpable abdominal contractions when standing and she could not lie flat on her back. Camptocormia did not improve with sensory tricks. Titration of PD medications partially improved symptoms, and adjunctive BTX injections were performed.
RESULTS: 200 units of BTX were injected under EMG guidance to each RA muscle. EMG activity during voluntary contraction of the RA was robust on the right and minimal on the left. 8 weeks later, there was marked reduction in right but not left abdominal painful contractions and minimal improvement in posture. CT scan of the abdomen confirmed surgical excision of the left RA, which measured 2-6 mm in thickness, compared to 6-9mm on the right. Subsequent EMG guided BTX injection of 200 units to the left EO and 200 units to the right RA resulted in more robust improvement. Compensated truncal flexion was 20degrees, she could lie flat on the exam table, and could stand erect with a sensory trick.
CONCLUSIONS: EO muscle injections should be considered in cases of dystonic camptocormia refractory to usual RA injections.
Authors/Disclosures
Subhashie Wijemanne, MD (Parkinson's, Restless Legs & Movement Disorder Specialists)
PRESENTER 		No disclosure on file
Joohi Jimenez Shahed, MD, FAAN (Icahn School of Medicine at Mount Sinai) Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BlueRock. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Treefrog. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for RebrAIn. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PhotoPharmics. Dr. Jimenez Shahed has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Emalex. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. The institution of Dr. Jimenez Shahed has received research support from Amneal. The institution of Dr. Jimenez Shahed has received research support from Annovis. The institution of Dr. Jimenez Shahed has received research support from SAGE. The institution of Dr. Jimenez Shahed has received research support from Ono Pharmaceuticals. The institution of Dr. Jimenez Shahed has received research support from BlueRock. The institution of Dr. Jimenez Shahed has received research support from Neuron23. Dr. Jimenez Shahed has received personal compensation in the range of $0-$499 for serving as a Faculty with Movement Disorders Society. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with 好色先生. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Parkinson Foundation.
No disclosure on file