Botulinum Neurotoxin Treatment of Unusual and Rare Painful Disorders

  • Bahman Jabbari


Botulinum neurotoxins (BoNTs) can relieve painful muscle spasms through inhibition of acetylcholine release and alleviate neuropathic pain via blocking the release of pain mediators such as calcitonin gene-related peptide (CGRP), glutamate, substance P (SP), and others (detailed in Chap. 2). In addition to the common pain disorders discussed in the preceding chapters, data is now available on the possible efficacy of BoNTs in alleviating pain in uncommon and rare disorders.

In this chapter, three uncommon and rare conditions—stiff-person syndrome, painful legs–moving toes, and painful camptocormia—are discussed. The limited data from the literature about the use of BoNT in these conditions is presented. Case reports and video clips are included from the author’s experience to illustrate the clinical features and the technique of BoNT injection employed to relieve pain.


Stiff-person syndrome Painful legs–moving toes Camptocormia Botulinum toxin Botulinum neurotoxin Onabotulinum toxin Abobotulinum toxin Incobotulinum toxin 

Supplementary material

Video 16.1

Case 16-1. Involuntary muscle contractions of the right rectus and vastus lateralis muscles in a patient with stiff-person syndrome (MOV 14081 kb)

Video 16.2

A patient with 10-year history of SPS and marked stiffness of the neck and shoulder muscles—onabotulinumtoxinA injections are given into the areas of local pain (MOV 85958 kb)

Video 16.3

Example of painful legs–moving toes (MOV 48703 kb)

Video 16.4

Example of painful legs–moving toes (MOV 5203 kb)

Video 16.5

Camptocormia in Parkinson’s disease

Video 16.6

Camptocormia: EMG guided injections into rectus and oblique abdominal muscle

Video 16.7

Camptocormia: Patient of video-16.6 interview after 4 cycles of treatment


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Bahman Jabbari
    • 1
  1. 1.Botulinum Toxin Treatment ProgramYale School of MedicineNew HavenUSA

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