Article

Six patients with Parkinson's disease with deep brain stimulation who
were experiencing disabling foot dystonia were referred to the spasticity clinic
for a trial of botulinum toxin.
The foot and ankle muscles were injected with
onabotulinum toxin (Botox) to determine the effects on foot dystonia, pain and
lower limb functional outcomes. DESIGN : Case series. SUBJECTS : Six
patients with Parkinson's disease with deep brain stimulation experiencing
disabling foot dystonia. METHODS: Dystonic foot and ankle muscles were identified
and injected with 250-400 units botulinum toxin and re-coded pre- and 3 weeks
post-injection with the Burke Fahn Marsden Dystonia score, visual analogue score
of pain, Unified Parkinson's Disease Rating Scale (UPDRS) - lower limb score,
Timed up and Go test (TUG), 6-Minute Walk Test (6MWT), gait velocity, cadence in
an instrumented walkway, and Goal Attainment Scale (GAS). RESULTS: Three weeks
after botulinum toxin injection, significant improvements were noted in dystonia,
pain, UPDRS, 6MWT, gait velocity, and cadence. Five out of 6 patients improved on
the TUG test. Patients also reported improvements in their GAS goals. CONCLUSION:
Botox injection significantly improved foot dystonia, pain and lower limb
functional outcomes in patients with Parkinson's disease with deep brain stimulation.

Langue : ANGLAIS