Split-screen video demonstration of sonography-guided muscle identification and injection of botulinum toxin

Authors

  • Urban M. Fietzek MD,

    1. Neurologisches Krankenhaus München, Center for Parkinson's Disease and Movement Disorders, München, Germany
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  • A. Sebastian Schroeder MD,

    1. Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauners' Children's Hospital, Ludwig-Maximilians-University Munich, München, Germany
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  • Jörg Wissel MD, PhD,

    1. Neurologische Rehabilitationsklinik, Beelitz-Heilstätten, Beelitz-Heilstätten, Germany
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  • Florian Heinen MD, PhD,

    1. Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauners' Children's Hospital, Ludwig-Maximilians-University Munich, München, Germany
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  • Steffen Berweck MD, PhD

    Corresponding author
    1. Department of Pediatric Neurology and Developmental Medicine, Dr. von Hauners' Children's Hospital, Ludwig-Maximilians-University Munich, München, Germany
    2. Treatment Centre Vogtareuth, Specialist Centre for Neuropediatric Rehabilitation, Vogtareuth, Germany
    • Treatment Centre Vogtareuth, Specialist Centre for Neuropediatric Rehabilitation, Krankenhausstr. 20, 83569 Vogtareuth, Germany
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  • Potential conflict of interest: Nothing to report.

Abstract

A standardization of injection procedures for the various botulinum toxin (BoNT) indications has not been achieved to date. One established option to guide the therapist's needle is sonography guidance. It provides real-time visualization of the injection process, which is quick, allows perfect precision, and the procedure as such is painless. To demonstrate these qualities, we have recorded six split-screen video segments that show the handling of the probe and the needle during BoNT injections concurrently with the respective cross-sectional sonography recordings. The video sequences show differentiation of the pollicis longus muscle and individual finger flexor fascicles, needle tracking, and real-time sonography-guided injection of the gastrocnemius, rectus femoris, and iliopsoas muscles. We hope this short presentation will help to encourage a more widespread use of the technique as well as further research on sonography guidance for precise delivery of BoNT injections to various target muscles. © 2010 Movement Disorder Society

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