Intramuscular Pressure Before and After Botulinum Toxin in Chronic Exertional Compartment Syndrome of the Leg

Abstract

In this case series, BoNT-A reduced the IMP and eliminated exertional pain in anterior or anterolateral CECS of the leg for up to 9 months after the intervention. The mode of action of BoNT-A is still unclear. A randomized controlled study should be carried out to determine whether BoNT-A can be used as a medical alternative to surgical treatment.

Botulinum Toxin as a Treatment for Functional Popliteal Artery Entrapment Syndrome

“…The amount of BoNT-A to be injected (i.e., the smallest effective and non paralyzing dose) was chosen based on literature data and the authors' experience in the field of spasticity (3,23), mus culoskeletal disorders (24,29,34), and exertional compart ment syndrome (15). After EMG localization of the muscles, BoNT-A was injected in the proximal and medial parts of each gastrocnemius (both internal and external head) because they were thought to be responsible for the compression at the level of the popliteal fossa.…”

“…Re cently, Botulinum toxin A (BoNT-A) has been proposed as an alternative approach to reduce the volume and/or tonus of gastrocnemius muscles in patients with FPAES (11). In deed, BoNT-A has been used successfully for the treatment of unaesthetic masseter (2,16) and calf hypertrophy (14,20), postsciatica muscle hypertrophy (6,29), and muscle patholo gies, such as exertional compartment syndrome (15,18,19).…”

MRI of Musculotendinous Injuries—Part I: “Non-strain” Injuries

“…Treatment Non-operative treatments are prescribed initially, and there are some reports of success (e.g., with forefoot running technique [39] or botulinum toxin injection [40]). Fasciotomy is the traditional definitive treatment of choice.…”

Clostridial neurotoxins

“…Thus, the myorelaxing and atrophic effects of botulinum toxin brings relief from pain [266]. Since the fading of pain has been reported very often by patients before muscle weakness is observed, it has been hypothesized that BoNT may also cause some analgesia.…”