Botulinum Toxin to Control an Incapacitating Tic in a Child with a Clavicular Fracture

Chen, Y.; Thalayasingam, Priya

doi:10.1177/0310057x1003800624

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…One goal of the multidisciplinary approach is to provide a more holistic and individualized approach to care, addressing current challenges and anticipating future situations. For instance, Chen et al 35 reported on a patient managed mainly by psychology without pharmacologic therapy despite the progression of tics, which were described as slow writhing movements involving his neck and shoulder muscles. This culminated in an acute presentation with a clavicular fracture.…”

Section: Resultsmentioning

confidence: 99%

Scoping Review of Multidisciplinary Care in Tourette Syndrome

Willford

Deeb

2023

Movement Disord Clin Pract

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Objective To review current multidisciplinary care practices in patients with Tourette syndrome (TS). Background Individuals with TS can have multiple symptoms and comorbidities and require treatment to encompass all of their needs. A multidisciplinary research or care model approaches the situation/problem from all sides and uses multiple perspectives. Methods A database search of Medline (using Pubmed), PsychINFO, and Scopus was performed using keywords related to multidisciplinary care and TS. The authors then screened the results for relevant information using a standardized extraction form to collect data. Next, relevant codes from text analysis were extracted with a final list agreed on with author consensus. Finally, we inferred common themes. Results The search revealed 2304 citations, and 87 were selected for full‐text analysis. One additional article was identified by manual search. Thirty‐one citations were deemed relevant. Multidisciplinary team members typically included a psychiatrist or child psychiatrist, a neurologist or child neurologist, and a psychologist or therapist at the core. Four primary benefits were associated with multidisciplinary care: establishing the diagnosis, managing the complexity of TS and its associated comorbidities, averting complications, and evaluating advanced therapies. Limitations include possible poor team dynamics and rigidity in the approach leading to an algorithmic treatment plan. Conclusions A multidisciplinary care model for TS is the preferred model advocated by patients, physicians, and organizations. This scoping review reveals that the impetus for multidisciplinary care rests on four primary benefits, but there is a lack of empirical evidence for defining and evaluating its use.

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Section: Resultsmentioning

confidence: 99%

Scoping Review of Multidisciplinary Care in Tourette Syndrome

Willford

Deeb

2023

Movement Disord Clin Pract

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“…White et al described the use of botulinum toxin as an adjunct therapy in a case of a periprosthetic scapular spine fracture, whereby the botulinum toxin was injected into the deltoid muscle to reduce potential strain from the muscle on the surrounding fracture site [ 23 ]. Chen and Thalayasingam reported a case of botulinum toxin use in a child with a clavicular fracture and motor tic disorder to control the pain at the fracture site caused by the tics, as well as provide adequate immobilization of the fracture for healing [ 17 ]. In a case series by Shilt et al, botulinum toxin was utilized in 5 male patients to achieve controlled immobilization and prevention of tendon repair failure following proximal hamstring avulsion repair [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin for Immobilization of a Surgically Managed Distal Humerus Fracture in Parkinson’s Disease-Associated Psychosis: A Case Report

et al. 2023

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Patient: Female, 75-year-old Final Diagnosis: Healing fracture Symptoms: Deformity • pain Clinical Procedure: Open reduction and internal fixation of the right humerus • revision of open reduction and internal fixation of the right humerus Specialty: Orthopedics and Traumatology Objective: Unusual clinical course Background: Attainment of extremity immobilization in orthopedic trauma patients experiencing psychosis is often uniquely challenging. Many fractures, including those of the distal humerus, require a period of immobilization postoperatively to optimize fracture healing. Patients with Parkinson’s disease have also been shown to have lower rates of union after fracture compared to the general population. The combination of Parkinson’s disease and associated psychosis requires heightened attention to those parameters that may hinder fracture healing, such as inadequate immobilization of the fracture. Botulinum toxin has previously been described as a potential adjunctive therapy for fracture immobilization but has not yet been described in the setting of distal humerus fractures. Case Report: A 75-year-old woman with Parkinson’s disease-associated psychosis presented 2 weeks after open reduction and internal fixation of a distal third humeral shaft fracture due to failure of fixation and episodes of violent hallucinations. The patient underwent irrigation and debridement, and revision open reduction and internal fixation. Given her uncontrolled hallucinations, intramuscular botulinum toxin injections were given to the right triceps, biceps, and brachialis muscles to aid in the immobilization of the right extremity and protect the surgical site during the perioperative period. The patient subsequently followed up at the clinic 3 months postoperatively with ongoing fracture healing, evidenced by bridging callous and bone formation on radiographs, as well as a return of motion to the extremity. Conclusions: Botulinum toxin may be a safe and effective adjunct for fracture immobilization in patients who are difficult to immobilize and have high fixation failure risk.

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“…In another animal study, rat femur fractures experienced increased biomechanical and histopathologic healing when treated with botulinum toxin A compared to no treatment, though the fracture callus diameter was smaller [ 14 ]. In one of the few clinical case reports on the topic, a patient with an undefined tic disorder sustained clavicle fracture treated with surgical fixation and botulinum toxin A injection, ultimately allowing fracture union without complication [ 15 ]. Finally, a retrospective review by Freibott et al [ 16 ] demonstrated the clinical utility of botulinum toxin injections in the treatment of post-traumatic elbow stiffness caused by heterotopic ossification.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin as adjunct therapy in surgical management of a periprosthetic scapular spine fracture: a case report

White

Brusalis

Wellman

et al. 2022

Clin Shoulder Elbow

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Six months after undergoing reverse total shoulder arthroplasty (RSA) a 73-year-old woman sustained a periprosthetic scapular spine fracture following a fall. She was treated with open reduction and internal fixation (ORIF), followed by botulinum toxin injection into the deltoid muscle to temporarily minimize strain at the fracture. Fracture union was achieved by three months, with excellent clinical function more than one year following fracture fixation and full resolution of deltoid function. Scapular spine fracture following RSA can be treated with ORIF and temporary deltoid paralysis using botulinum toxin in the immediate postoperative period to safely support fracture healing.

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Botulinum Toxin to Control an Incapacitating Tic in a Child with a Clavicular Fracture

Cited by 5 publications

References 13 publications

Scoping Review of Multidisciplinary Care in Tourette Syndrome

Scoping Review of Multidisciplinary Care in Tourette Syndrome

Botulinum Toxin for Immobilization of a Surgically Managed Distal Humerus Fracture in Parkinson’s Disease-Associated Psychosis: A Case Report

Botulinum toxin as adjunct therapy in surgical management of a periprosthetic scapular spine fracture: a case report

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