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Treatment of Raynaud’s phenomenon with botulinum toxin type A

Abstract

Raynaud’s phenomenon (RP), an episodic vasospasm of the peripheral arteries, is quite common in general population. The current therapies of RP are limited by efficacy, side effects, and polypharmacy concerns. Botulinum toxin type A (BTX-A) local injections have been reported for the treatment of RP, but the injection sites, concentration and dose of BTX-A were different from each other in previous trials. In addition, so far, there have been no reports concerning local injection of BTX-A in Asian RP patients. Ten patients with RP in China were included in this retrospective study. All the patients had intractable pain and were non-responsive to conservative and/or medical therapy. A patterned BTX-A injection was performed in RP patients, guided by ultrasonography. BTX-A was injected as 20 u/ml devoid of preservatives. Outcomes were measured by ultrasonography, surface temperature, visual analog scale (VAS) for clinical symptoms (pain, numbness, stiffness and swelling), and changes in ulcers or gangrene. Overall, a great improvement in artery flow velocity (P < 0.01), surface temperature (P < 0.01), ulcer and VAS for clinical symptoms, was observed after BTX-A local injection. Complications were very rarely found, and no patients complained of hand weakness and bruise. BTX-A patterned injection guided by ultrasonography might be a useful therapeutic tool in the management of intractable RP.

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Acknowledgments

The authors sincerely thank the patients for their help and willingness to participate in this study. The work was supported by “Fundamental Research Funds for Central Universities” (No: 1508219065) and “National Natural Science Foundation of China” (No: 81470582). We thank Dr. Qianglin Duan for critical review of this manuscript.

Conflict of interest

The authors declare that there is no financial or other conflict of interest in relation to this research and its publication.

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Correspondence to Lingjing Jin.

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Zhang, X., Hu, Y., Nie, Z. et al. Treatment of Raynaud’s phenomenon with botulinum toxin type A. Neurol Sci 36, 1225–1231 (2015). https://doi.org/10.1007/s10072-015-2084-6

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Keywords

  • Botulinum toxin
  • Raynaud’s phenomenon
  • Ultrasonography
  • Therapy