Botulinum toxin a is effective in treating trismus associated with postradiation myokymia and muscle spasm

Abstract

a normal examination in the same patient. References 1. 2.3. 4. 5. 6. 7.8. 9. 10. 11. 12. 13.14. 15. 16. 17.18. Sandyk R. The endogenous opioid system in the neurological disorders of the basal ganglia. Life Sci 1985;37:1655-1663. Bosse A, Kuschinsky K. Alterations of dopaminergic neurotransmission after chronic morphic treatment: pre-and postjunctional studies in striatal tissue. Arch Pharmacol Das D, Rogers J, Michael-Titus AT. Comparative study of the effects of mu, delta and kappa opioid agonists on 3Hdopamine uptake in rat striatum and nucleus accumbens. Neuropharmacology 1994;33:221-226. Funada M, Suzuki T, Misawa M. The role of dopamine DIreceptors in morphine-induced hyperlocomotion in mice. Neurosci Lett 1194;169:1-4. Nutt JG, Rosin AJ, Eisler T, Calne DB, Chase TN. Effect of an opiate antagonist on movement disorders. Arch Neurol 1978;35:810-811. Wasserman S , Yarhr MD. Choreic movements induced by the use of methadone. Arch Neurol 1980;37:727-728, Lieberman AN, Goldstein M. Reversible parkinsonism related to meperidine. N Engl J Med 1985;312:509. Christian CM, Waller JL, Moldenhauer CC. Postoperative rigidity following fentanyl anesthesia. Anesthesiology 1983; Scott JC, Sarnquist FH. Seizure-like movements during a fentanyl infusion with absence of seizure activity in a simultaneous EEG recording. Anesthesiology 1985;62:812-814. Mirenda J, Tabatabai M, Wong K. Delayed and prolonged Ref e r e n c e s

Botulinum toxin B increases mouth opening in patients with spastic trismus

“…Locally injected, BoNT is taken up into the nerve terminal via endocytosis [12], and, by proteolytic cleavage of the SNARE proteins SNAP‐25 (BoNT/A) or Synaptobrevin (BoNT/B) which are both necessary for the acetylcholine vesicles’ fusion with the cell membrane [13,14], reduces the cholinergic peripheral neurotransmission for a limited time [15]. Therefore, a rational symptomatic therapy of hypertonia of the jaw muscles are local injections with BoNT and this was shown in single cases for a variety of conditions [16–19], and for patients with traumatic brain injury or following a stroke [5,6,8,20].…”

Botulinum Neurotoxins and Cancer—A Review of the Literature

“…One publication reported a 50 year-old man with adenocarcinoma of the soft palate, who following radiotherapy, developed trismus and myokymia of the masseter muscles. Trismus and myokymia improved after injection of 25 units of onaA into each masseter muscle [23]. Two other manuscripts described improvement of central neuropathic pain in association with a mass lesion.…”

“…One publication reported a 50 year-old man with adenocarcinoma of the soft palate, who following radiotherapy, developed trismus and myokymia of the masseter muscles. Trismus and myokymia improved after injection of 25 units of onaA into each masseter muscle [23]. Two other manuscripts described improvement of A total of 10 of 11 studies used a standardized scale for pain measurement (Visual Analogue Scale: VAS) which in 9 of 10 demonstrated statistically significant improvement of local pain at 4-8 post-injection weeks compared to baseline (p < 0.05) ( Table 1).…”

Head and Neck Muscle Spasm After Radiotherapy

“…Painful chronic bladder spasms have been reported as a consequence of radiation for cervical carcinoma, 1 and trismus has been reported as both an acute and late complication of upper aerodigestive tract radiotherapy with and without concurrent chemotherapy. [2][3][4] Radiation-induced trismus due to secondary myokymia of the masseter muscle after treatment for palatal adenocarcinoma has been treated effectively with botulinum toxin A in the past. 4 However, there are no reports in the literature describing painful spasms of the neck musculature after neck radiotherapy.…”

“…[2][3][4] Radiation-induced trismus due to secondary myokymia of the masseter muscle after treatment for palatal adenocarcinoma has been treated effectively with botulinum toxin A in the past. 4 However, there are no reports in the literature describing painful spasms of the neck musculature after neck radiotherapy. The purpose of this study is to introduce the concept of painful postirradiation muscle spasms of the head and neck musculature specifically of the sternocleidomastoid muscle and the use of botulinum toxin A to help manage the disorder.…”