Abstract
Objective: The purpose of this case study is to present the findings of combining botulinum toxin type A (BoNT-A) and cervical spine manual therapy to address masseter muscle spasticity in a patient with Alzheimer-type dementia. Case Report: A 78-year-old woman with bilateral spasticity of the masseteric regions for 2 years was referred for physiotherapy. She had trismus and bruxism, and could neither close nor open her mouth normally; thus, she was unable to be fed orally in a normal manner. Intervention and Outcome: The patient underwent combined treatment with BoNT-A and cervical spine manual therapy. A medical physician (neurologist) performed the BoNT-A injections into 2 points at the center of the lower third of the masseter muscle. A physical therapist performed manual therapy interventions targeted at the cervical spine. Manual therapy started the day after the BoNT-A injection and continued for 5 sessions per week for a total period of 2 weeks. Clinical outcomes were measured including spasticity (Modified Ashworth Scale), functionality (Barthel Index), and jaw opening. Outcomes were conducted at baseline, 2 weeks after treatment, and at 2-month follow-up session after finishing the treatment. The patient improved in all of the outcomes at the end of treatment, and these results were maintained during the follow-up. After treatment, the patient was able to feed with minimal caregiver dependency because oral feeding was possible. Conclusion: The patient in this study responded positively to a combination of BoNT-A and manual therapy, resulting in decreased masseter muscles spasticity and improved trismus and bruxism.
| Original language | English |
|---|---|
| Pages (from-to) | 280-285 |
| Number of pages | 6 |
| Journal | Journal of Chiropractic Medicine |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Dec 2012 |
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Keywords
- Alzheimer disease
- Botulinum toxin type A
- Masseter muscle, cervical spine
- Muscle spasticity
- Physiotherapy
- Stroke
ASJC Scopus subject areas
- Chiropractics
Cite this
Botulinum toxin type A combined with cervical spine manual therapy for masseteric hypertrophy in a patient with Alzheimer-type dementia : a case report. / Villafañe, Jorge H.; Fernandez-de-las-Peñas, Cesar; Pillastrini, Paolo.
In: Journal of Chiropractic Medicine, Vol. 11, No. 4, 12.2012, p. 280-285.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Botulinum toxin type A combined with cervical spine manual therapy for masseteric hypertrophy in a patient with Alzheimer-type dementia
T2 - a case report
AU - Villafañe, Jorge H.
AU - Fernandez-de-las-Peñas, Cesar
AU - Pillastrini, Paolo
PY - 2012/12
Y1 - 2012/12
N2 - Objective: The purpose of this case study is to present the findings of combining botulinum toxin type A (BoNT-A) and cervical spine manual therapy to address masseter muscle spasticity in a patient with Alzheimer-type dementia. Case Report: A 78-year-old woman with bilateral spasticity of the masseteric regions for 2 years was referred for physiotherapy. She had trismus and bruxism, and could neither close nor open her mouth normally; thus, she was unable to be fed orally in a normal manner. Intervention and Outcome: The patient underwent combined treatment with BoNT-A and cervical spine manual therapy. A medical physician (neurologist) performed the BoNT-A injections into 2 points at the center of the lower third of the masseter muscle. A physical therapist performed manual therapy interventions targeted at the cervical spine. Manual therapy started the day after the BoNT-A injection and continued for 5 sessions per week for a total period of 2 weeks. Clinical outcomes were measured including spasticity (Modified Ashworth Scale), functionality (Barthel Index), and jaw opening. Outcomes were conducted at baseline, 2 weeks after treatment, and at 2-month follow-up session after finishing the treatment. The patient improved in all of the outcomes at the end of treatment, and these results were maintained during the follow-up. After treatment, the patient was able to feed with minimal caregiver dependency because oral feeding was possible. Conclusion: The patient in this study responded positively to a combination of BoNT-A and manual therapy, resulting in decreased masseter muscles spasticity and improved trismus and bruxism.
AB - Objective: The purpose of this case study is to present the findings of combining botulinum toxin type A (BoNT-A) and cervical spine manual therapy to address masseter muscle spasticity in a patient with Alzheimer-type dementia. Case Report: A 78-year-old woman with bilateral spasticity of the masseteric regions for 2 years was referred for physiotherapy. She had trismus and bruxism, and could neither close nor open her mouth normally; thus, she was unable to be fed orally in a normal manner. Intervention and Outcome: The patient underwent combined treatment with BoNT-A and cervical spine manual therapy. A medical physician (neurologist) performed the BoNT-A injections into 2 points at the center of the lower third of the masseter muscle. A physical therapist performed manual therapy interventions targeted at the cervical spine. Manual therapy started the day after the BoNT-A injection and continued for 5 sessions per week for a total period of 2 weeks. Clinical outcomes were measured including spasticity (Modified Ashworth Scale), functionality (Barthel Index), and jaw opening. Outcomes were conducted at baseline, 2 weeks after treatment, and at 2-month follow-up session after finishing the treatment. The patient improved in all of the outcomes at the end of treatment, and these results were maintained during the follow-up. After treatment, the patient was able to feed with minimal caregiver dependency because oral feeding was possible. Conclusion: The patient in this study responded positively to a combination of BoNT-A and manual therapy, resulting in decreased masseter muscles spasticity and improved trismus and bruxism.
KW - Alzheimer disease
KW - Botulinum toxin type A
KW - Masseter muscle, cervical spine
KW - Muscle spasticity
KW - Physiotherapy
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84870018888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870018888&partnerID=8YFLogxK
U2 - 10.1016/j.jcm.2012.10.004
DO - 10.1016/j.jcm.2012.10.004
M3 - Article
C2 - 23843761
AN - SCOPUS:84870018888
VL - 11
SP - 280
EP - 285
JO - Journal of Chiropractic Medicine
JF - Journal of Chiropractic Medicine
SN - 1556-3707
IS - 4
ER -