A Moving Residual Limb: Botulinum Toxin to the Rescue

• Main Authors: Briand Marie-Michèle, Boudier-Réveret Mathieu, Rodrigue Xavier, Sirois Geneviève, Chang Min Cheol
• Format: Article
• Language: English
• Published: De Gruyter 2020-02-01
• Series: Translational Neuroscience
• Subjects: amputation stump; myoclonus; movement disorders; botulinum toxin
• Online Access: https://doi.org/10.1515/tnsci-2020-0006

Movement disorders post-amputation are a rare complication and can manifest as the jumping stump phenomenon, a form of peripheral myoclonus. The pathophysiology remains unknown and there is currently no standardized treatment. We describe the case of a 57-year-old male with unremitting stump myoclonus, starting one month after transtibial amputation, in his residual limb without associated phantom or neurological pain. The consequence of the myoclonus was a reduction in prosthetic wearing time. Failure to respond to oral medication led us to attempt the use of botulinum neurotoxin Type A injections in the involved muscles of the residual limb. Injection trials, over a two-year period, resulted in an improvement of movement disorder, an increased prosthetic wearing time and a higher satisfaction level of the patient. Injection of botulinum toxin type A should be considered as an alternative treatment for stump myoclonus to improve prosthetic wearing time and comfort.