Botulinum toxin injection strategy of intractable and relapsed piriformis syndrome: A case report.

Abstract

RATIONALE:

Piriformis syndrome (PS) is neuromuscular disorder caused by sciatic nerve compression by piriformis muscle and related to sciatic-type pain. When the conservative care fails, local injection or surgery can be also performed into piriformis. In recent years, botulinum toxin (BoNT) has also been considered as a new therapeutic option of piriformis syndrome.

PATIENT CONCERNS:

A man in his late 40s came to pain clinic for left low back pain. The symptom was aggravated with sitting position.

DIAGNOSIS:

Piriformis syndrome.

INTERVENTIONS:

The patient underwent BoNT injection with 100 IU with 2 mL into piriformis muscle for piriformis syndrome treatment, and his pain was relieved. However, it recurred 8 months later. BoNT injection was repeated with 100 IU with 5 mL.

OUTCOMES:

At the time of this writing, his pain was reduced for 2 years without any medication.

LESSONS:

We report a case of treating relapsed piriformis syndrome with BoNT injection of different dilution volume, suggesting that the higher the dilution volume, the more effective for therapeutic effect of BoNT.

• Authors: So Young Kwon, Eun Hwa Jun, Seong Jin Park, Yumi Kim
• Journal: Medicine (Medicine (Baltimore)) Vol. 101 Issue 42 Pg. e30950 (Oct 21 2022) ISSN: 1536-5964 [Electronic] United States
• PMID: 36281083 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Botulinum Toxins

Topics

• Male
• Humans
• Piriformis Muscle Syndrome (drug therapy)
• Sciatic Nerve
• Sciatic Neuropathy
• Botulinum Toxins (therapeutic use)
• Low Back Pain (drug therapy)