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Therapeutic Uses of Botulinum Toxin by Hervé Rousseau, Jean-Philippe Verhoye, Jean-Francois Heautot

By Hervé Rousseau, Jean-Philippe Verhoye, Jean-Francois Heautot

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Botulinum toxin type A for radiation-induced trismus and facial pain: a case report. Arch Phys Med Rehabil 2004;85:E37. 9. Chou WW, Puri DR, Lee NY. Intensity-modulated radiation therapy for head and neck cancer. Expert Rev Anticancer Ther 2005;5:515–521. 10. Saarto T, Janes R, Tenhunen, Kouri M. Palliate radiotherapy in the treatment of skeletal metastases. Eur J Pain 2002;6:323–330. 11. Chow E, Wu J, Loblaw A, Perez CA. Radiotherapeutic approaches to metastatic disease. World J Urol 2003;21:229–242.

Activities that involve extension of the spine, such as lying supine or prone, decrease the canal diameter exacerbating symptoms. Patients will often complain of pain in the legs while walking that is relieved by sitting. Coccyx Pain (Coccygodynia, Coccydynia) The coccyx is the most inferior portion of the spine, most commonly called the tail bone. Pain originating from this area usually has an unknown etiology but has been associated with a sudden fall and childbirth. Patients present with tenderness over the coccyx and pain while sitting.

A 30-gage needle should be used to inject at least four separate sites within the temporalis. The major potential complications of injection for radiation-induced trismus include infection and bleeding. Dysphagia and dysarthria are uncommon at lower doses of BTX but become more likely as doses are increased. Radiation-induced cervical dystonia can result not only from the treatment of head and neck cancers, but from treatment of any tumor treated with radiation that involves occiput, cervical spine, or upper thoracic spine (48).

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