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 23 - Botulinum neurotoxin A treatment for ischemic digits
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
Raynaud’s phenomenon
Raynaud’s phenomenon is a vasospastic disorder that affects over 9 million people in the USA (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2006). Maurice Reynaud’s description of arterial insufficiency to the fingers in 1862 led to his name being the eponym of this condition. He described the process as a “local asphyxia of the extremities” as a result of “increased irritability of the central parts of the cord presiding over vascular innervation.” Raynaud’s phenomenon is nine times more common in females and typically occurs between the ages of 15–40 years. These patients have an exaggerated vasoconstriction of their digital arteries in response to certain environmental triggers, which leads to pale, cold, numb and sometimes painful digits. These symptoms can last minutes to hours and may reoccur several times through the day. For the majority of patients, the symptoms are simply bothersome, but for 20% the symptoms are so severe that they seek medical attention. The digital artery vasospasm leads to diminished blood supply to the fingertips, which causes pain, ulcerations and disuse. Many patients require digit amputations for recalcitrant ulcers or exposure of the distal phalanx. The resultant digit ischemia may be also associated with considerable morbidity associated with loss of function, disability and depression.
Primary Raynaud’s disease is an idiopathic condition, and secondary Raynaud’s disease is associated with other connective tissue disorders. Secondary Raynaud’s disease affects 90% of patients with scleroderma, 90% of patients with mixed connective tissue disease, 33% of patients with lupus and 33% of people with Sjögren’s syndrome. The pathophysiology of primary versus secondary Raynaud’s disease is likely different, with secondary Raynaud’s disease invariably causing more severe and debilitating symptoms (Figs. 23.1 and 23.2).
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- Information
- Manual of Botulinum Toxin Therapy , pp. 203 - 209Publisher: Cambridge University PressPrint publication year: 2014