Use of botulinum toxin type A for the treatment of radiation therapy–induced myokymia and neuromyotonia in a dog
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Cleo P. Rogatko [2] ; Alexander de Lahunta ; Eric N. Glass [2] ; Marc Kent [1] ; James J. Hammond [3]
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[1] University of Georgia
University of Georgia
Estados Unidos
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[2] Section of Neurology and Neurosurgery, Red Bank Veterinary Hospital, Tinton Falls, N
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[3] Department of Neurology and Neurosurgery, Pieper Memorial Veterinary Center, Middletown
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- Localización: JAVMA: Journal of the American Veterinary Medical Association, ISSN-e 0003-1488, Vol. 248, Nº. 5, 2016, págs. 532-537
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
CASE DESCRIPTION A 5-year-old castrated male Maltese was evaluated for intermittent clinical signs of muscle cramping and abnormal movements of the skin of the right pelvic limb at the site where an infiltrative lipoma had twice been resected. After the second surgery, the surgical field was treated with radiation therapy (RT). The clinical signs developed approximately 14 months after completion of RT.
CLINICAL FINDINGS When clinical signs were present, the right biceps femoris and semitendinosus muscles in the area that received RT were firm and had frequently visible contractions, and the skin overlying those muscles had episodic vermiform movements. Electromyography of those muscles revealed abnormal spontaneous activity with characteristics consistent with myokymic discharges and neuromyotonia. Magnetic resonance imaging of the affected leg revealed no evidence of tumor regrowth. The myokymia and neuromyotonia were considered secondary to RT.
TREATMENT AND OUTCOME 4 U of Clostridium botulinum toxin type A (BoNT-A) neurotoxin complex was injected into the affected muscles at each of 6 sites twice during a 24-hour period (ie, 48 U of BoNT-A were administered). The clinical signs were completely resolved 10 days after BoNT-A treatment and were controlled by repeated BoNT-A treatment every 3 to 4 months for > 1 year.
CLINICAL RELEVANCE To our knowledge, this is the first report of myokymia and neuromyotonia secondary to RT in a dog. For the dog of this report, injection of BoNT-A into the affected muscles was safe, effective, and easy to perform.
