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Botulinum toxin A in functional popliteal entrapment syndrome: a new approach to a difficult diagnosis

  • Neurology and Preclinical Neurological Studies - Short communication
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Abstract

Functional Popliteal Entrapment Syndrome (FPES) is caused by compression of neurovascular structures in the popliteal fossa by hypertrophic muscles, provoking severe leg pain with exercise. Treatment is limited to myotomy of hypertrophic musculature. 8 FPES patients underwent imaging and exercise studies, before receiving botulinum toxin A injections (BTX-A) into the gastrocnemius and plantaris muscles. 81.3 % of patients reported clinical improvement on follow-up, and pathological ankle–brachial indices were normalized. BTX-A injection may present a new, safe, effective and non-invasive approach to FPES.

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Acknowledgments

We thank Georg Ebersbach and Doreen Gruber for discussion of results and assistance in statistical analysis.

Conflict of interest

No conflicts of interest to disclose.

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Authors and Affiliations

  1. Movement Disorders Clinic, Paracelsusring 6A, 14547, Beelitz-Heilstätten, Germany

    Florin Gandor

  2. Department of Neurology, St. Vincent’s Hospital, Sydney, Australia

    Florin Gandor, Stephen Tisch & Paul Darveniza

  3. Department of Vascular Surgery, St. Vincent’s Hospital, Sydney, Australia

    Anthony J. Grabs

  4. Narrabeen Sports and Exercise Medicine Centre, Sydney Academy of Sport, Narrabeen, Australia

    Anthony J. Delaney

  5. Department of Radiology, St. Vincent’s Hospital, Sydney, Australia

    Lourens Bester

Authors
  1. Florin Gandor
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  2. Stephen Tisch
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  3. Anthony J. Grabs
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  4. Anthony J. Delaney
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  5. Lourens Bester
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  6. Paul Darveniza
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Corresponding author

Correspondence to Florin Gandor.

Electronic supplementary material

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702_2014_1197_MOESM1_ESM.tif

Supplementary material 1 (TIFF 13681 kb). Angiography of a patient with FPES: complete occlusion of the right and significant compression of the left popliteal artery. (A: angiography of the right leg, B: of the left leg. x.1: investigations at rest. x.2: provoked plantar flexion with the angiography table tilted at 30°). Arrows indicate site of compression of popliteal artery by musculature during forced plantar flexion

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Gandor, F., Tisch, S., Grabs, A.J. et al. Botulinum toxin A in functional popliteal entrapment syndrome: a new approach to a difficult diagnosis. J Neural Transm 121, 1297–1301 (2014). https://doi.org/10.1007/s00702-014-1197-z

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  • DOI: https://doi.org/10.1007/s00702-014-1197-z

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