A new treatment for cervical vertigo with botulinum toxin.

A new and unique treatment for cervical vertigo with botulinum toxin is presented for a woman who sustained neck trauma from being hit by a wave. A diagnosis of cervical vertigo and cervical dystonia was confirmed by history, physical exam, dystonia on EMG exam, and a negative test for benign paroxysmal positional vertigo. She experienced consistent resolution of her vertigo symptoms and pain after each treatment for a total of 5 treatments with botulinum toxin to the upper cervical muscles.

OnabotulinumtoxinA for Lower Limb Spasticity: Guidance From a Delphi Panel Approach.

Background: OnabotulinumtoxinA is approved for the treatment of upper and lower limb spasticity in adults. Guidance on common postures and onabotulinumtoxinA injection paradigms for upper limb spasticity has been developed via a Delphi Panel; however, similar guidance for lower limb spasticity has not been established.

Objective: To define a clinically recommended treatment paradigm for the use of onabotulinumtoxinA for each common posture among patients with poststroke lower limb spasticity (PSLLS) and to identify the most common PSLLS aggregate postures.

Ultrasound and Electromyography Guidance for Injection of the Longus Colli With Botulinum Toxin for the Treatment of Cervical Dystonia.

Cervical dystonia, also called spasmodic torticollis, is a painful condition in which neck muscles contract involuntarily, and may cause abnormal head position or movements. The primary (or first line of) treatment of cervical dystonia is chemodenervation with injection of botulinum toxin into the affected muscles. We report a case of a young man with idiopathic cervical dystonia who developed anterocollis (forward flexion of the neck) not responsive to prior scalene and sternocleidomastoid muscle injections.

Use of sonography in thoracic outlet syndrome due to a dystonic pectoralis minor.

Objective: For patients with thoracic outlet syndrome (TOS), it is important to determine the location of the neurovascular compression to achieve effective intervention.

Methods: The diagnostic workup for a 39-year-old man with TOS included a selective anesthetic block of the pectoralis minor muscle and duplex sonography before and after the block.

Results: The subclavian artery peak systolic flow velocity decreased after the block from 208 to 63 cm/s when the arm was in the abduction and external rotation position, indicating a reduction in the severity of focal arterial compression.

Botulinum toxin type A improves blood flow in vascular thoracic outlet syndrome.

A 28-yr-old man, diagnosed with vascular thoracic outlet syndrome, had his right anterior scalene muscle injected with botulinum toxin type A under ultrasound guidance. Subclavian artery flow rates were measured with Doppler ultrasound before and 3 wks after the injection. At 3 wks, symptoms had improved.

Quantitative reduction of saliva production with botulinum toxin type B injection into the salivary glands.

Drooling is common in patients with neurological disorders. Recently, botulinum toxin type B has been shown to be effective in the treatment of drooling. The authors present a unique case of a 57-year-old man with a history of a brainstem stroke and severe drooling.

Brain function early after stroke in relation to subsequent recovery.

This study aimed to characterize brain activation and perfusion early after stroke within cortical regions that would later change activation during recovery. Patients were studied serially after stroke (mean t1, = 16 days after stroke, t2 = 3.5 months later) using perfusion-weighted imaging and functional magnetic resonance imaging during finger movement.

Treatment of hyperhidrosis and drooling with botulinum exotoxin.

The treatment of focal hyperhidrosis and drooling with neurolysis of the neuroglandular junction is a relatively new and useful technique for managing such obvious conditions and improving the patient's quality of life. The treatment is safe, minimally invasive, and an effective alternative to other treatment modalities.

Motor cortex activation is preserved in patients with chronic hemiplegic stroke.

Many central nervous system conditions that cause weakness, including many strokes, injure corticospinal tract but leave motor cortex intact. Little is known about the functional properties of surviving cortical regions in this setting, in part because many studies have used probes reliant on the corticospinal tract. We hypothesized that many features of motor cortex function would be preserved when assessed independent of the stroke-affected corticospinal tract.

Long-term quantitative benefits of botulinum toxin type A in the treatment of axillary hyperhidrosis.

Background: Although axillary hyperhidrosis is readily treated with botulinum toxin, the time course of benefits is not well established.

Objective: To quantify the long-term effectiveness of botulinum toxin type A (BTX-A) for the treatment of axillary hyperhidrosis.

Methods: This was a double-blind, placebo-controlled study.