Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Chapter 1 The pretherapeutic history of botulinum neurotoxin
- Chapter 2 Botulinum neurotoxin: history of clinical development
- Chapter 3 Pharmacology of botulinum neurotoxins
- Chapter 4 Immunological properties of botulinum neurotoxins
- Chapter 5 Treatment of cervical dystonia
- Chapter 6 Examination and treatment of complex cervical dystonia
- Chapter 7 Ultrasound guidance for botulinum neurotoxin therapy: cervical dystonia
- Chapter 8 Treatment of blepharospasm
- Chapter 9 Botulinum neurotoxin in oromandibular dystonia
- Chapter 10 Treatment of focal hand dystonia
- Chapter 11 Botulinum neurotoxin therapy of laryngeal muscle hyperactivity syndromes
- Chapter 12 The use of botulinum neurotoxin in otorhinolaryngology
- Chapter 13 Treatment of hemifacial spasm
- Chapter 14 Spasticity
- Chapter 15 The use of botulinum neurotoxin in spastic infantile cerebral palsy
- Chapter 16 The role of ultrasound for botulinum neurotoxin injection in childhood spasticity
- Chapter 17 The use of botulinum neurotoxin in spasticity using ultrasound guidance
- Chapter 18 The use of botulinum neurotoxin in tic disorders and essential hand and head tremor
- Chapter 19 Treatment of stiff-person syndrome with botulinum neurotoxin
- Chapter 20 Botulinum neurotoxin applications in ophthalmology
- Chapter 21 Cosmetic uses of botulinum neurotoxins
- Chapter 22 Hyperhidrosis
- Chapter 23 Botulinum neurotoxin A treatment for ischemic digits
- Chapter 24 Botulinum neurotoxin in wound healing
- Chapter 25 Use of botulinum neurotoxin in neuropathic pain
- Chapter 26 The use of botulinum neurotoxin in the management of headache disorders
- Chapter 27 The use of botulinum neurotoxin in musculoskeletal pain and arthritis
- Chapter 28 Treatment of plantar fasciitis with botulinum neurotoxins
- Chapter 29 Use of botulinum neurotoxin in the treatment of low-back pain
- Chapter 30 Use of botulinum neurotoxin in the treatment of piriformis syndrome
- Chapter 31 Ultrasound-guided botulinum neurotoxin injections for thoracic outlet syndrome
- Chapter 32 Botulinum neurotoxin in the gastrointestinal tract
- Chapter 33 Botulinum neurotoxin applications in urological disorders
- Index
- References
Chapter 31 - Ultrasound-guided botulinum neurotoxin injections for thoracic outlet syndrome
Published online by Cambridge University Press: 05 February 2014
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Chapter 1 The pretherapeutic history of botulinum neurotoxin
- Chapter 2 Botulinum neurotoxin: history of clinical development
- Chapter 3 Pharmacology of botulinum neurotoxins
- Chapter 4 Immunological properties of botulinum neurotoxins
- Chapter 5 Treatment of cervical dystonia
- Chapter 6 Examination and treatment of complex cervical dystonia
- Chapter 7 Ultrasound guidance for botulinum neurotoxin therapy: cervical dystonia
- Chapter 8 Treatment of blepharospasm
- Chapter 9 Botulinum neurotoxin in oromandibular dystonia
- Chapter 10 Treatment of focal hand dystonia
- Chapter 11 Botulinum neurotoxin therapy of laryngeal muscle hyperactivity syndromes
- Chapter 12 The use of botulinum neurotoxin in otorhinolaryngology
- Chapter 13 Treatment of hemifacial spasm
- Chapter 14 Spasticity
- Chapter 15 The use of botulinum neurotoxin in spastic infantile cerebral palsy
- Chapter 16 The role of ultrasound for botulinum neurotoxin injection in childhood spasticity
- Chapter 17 The use of botulinum neurotoxin in spasticity using ultrasound guidance
- Chapter 18 The use of botulinum neurotoxin in tic disorders and essential hand and head tremor
- Chapter 19 Treatment of stiff-person syndrome with botulinum neurotoxin
- Chapter 20 Botulinum neurotoxin applications in ophthalmology
- Chapter 21 Cosmetic uses of botulinum neurotoxins
- Chapter 22 Hyperhidrosis
- Chapter 23 Botulinum neurotoxin A treatment for ischemic digits
- Chapter 24 Botulinum neurotoxin in wound healing
- Chapter 25 Use of botulinum neurotoxin in neuropathic pain
- Chapter 26 The use of botulinum neurotoxin in the management of headache disorders
- Chapter 27 The use of botulinum neurotoxin in musculoskeletal pain and arthritis
- Chapter 28 Treatment of plantar fasciitis with botulinum neurotoxins
- Chapter 29 Use of botulinum neurotoxin in the treatment of low-back pain
- Chapter 30 Use of botulinum neurotoxin in the treatment of piriformis syndrome
- Chapter 31 Ultrasound-guided botulinum neurotoxin injections for thoracic outlet syndrome
- Chapter 32 Botulinum neurotoxin in the gastrointestinal tract
- Chapter 33 Botulinum neurotoxin applications in urological disorders
- Index
- References
Summary
Introduction
Thoracic outlet syndrome (TOS) is a rare, often perplexing disorder caused by compression of neurovascular structures, leading to cervicogenic–brachial pain and other symptoms in neck and upper limb. Thoracic outlet syndrome is a group of disorders, not a single disorder, and patients may present with a wide variety of signs and symptoms. The wide range of symptoms and signs in TOS may confound clinicians unfamiliar with this condition (Sanders et al., 2008; Ferrante, 2012; Foley et al., 2012). Again, because TOS is a group of disorders, there is no “gold standard” to establish the diagnosis. This may lead to misdiagnosis or overdiagnosis of TOS in patients who present with symptoms suggesting TOS but who have other causes for their symptoms. It is, therefore, imperative that physicians be familiar with the range of symptoms and signs of TOS and testing that either supports or refutes this diagnosis. It is also critical that the diagnosis be correctly established before proceeding to invasive interventions for a presumed diagnosis of TOS, including botulinum neurotoxin (BoNT) injections.
One of the many emerging applications for BoNT therapy is for the treatment of musculoskeletal pain disorders, including TOS. While the efficacy of BoNT on decreasing pain associated with cervical dystonia and chronic migraine is established, the antinocioceptive mechanism of action of BoNT is not fully understood (Mense, 2004; Aoki, 2005). Reports of reduced pain with BoNT have been reported in various musculoskeletal pain disorders, including joint pain, myofascial pain and cerebral palsy (Barwood et al., 2000; Gobel et al., 2006; Singh et al., 2009). Although there are numerous reports in the literature citing the efficacy of BoNT for pain and other symptoms associated with TOS, additional research is needed to establish the role of BoNT in TOS and other pain disorders (Jordan et al., 2007; Danielson and Odderson, 2008; Torriani et al., 2010; Foley et al., 2012). The proposed mechanism of action includes reduced muscle spasm leading to decreased compression of neurovascular structures (Jordan et al., 2007; Tsao, 2007; Danielson and Odderson, 2008). Injection of BoNT into muscles also leads to denervation atrophy, which may reduce compression and neurogenic or vasogenic symptoms. It has also been reported that BoNT reduces the release of nocioceptive neurotransmitters, which could also be a contributing factor in reduced pain in TOS.
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- Manual of Botulinum Toxin Therapy , pp. 269 - 277Publisher: Cambridge University PressPrint publication year: 2014
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