Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

1 results

  • Chapter 28 - Botulinum Toxin in the Treatment for Ischemic Digits and Chronic Pain

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 230-236

  • Summary

    Raynaud’s phenomenon is a vasospastic disorder with a reported prevalence of between 3% and 5% of the general population, is nine times more common in females and typically occurs between the ages of 15–40 years. It may be primary or occur in the setting of connective tissue disorders. Exaggerated vasoconstriction of the digital arteries in response to certain environmental triggers, typically cold temperatures, leads to pale, cold, numb and sometimes painful digits. In extreme cases, digital artery vasospasm leads to diminished blood supply to the fingertips, which causes pain, disuse and exposure of the distal phalanx, and may necessitate amputation.

    Injection of botulinum neurotoxin (BoNT) into the hand, typically at the base of the fingers, produces increased blood flow, oxygenation saturation, pain reduction and promotion of ulcer healing, with prolonged benefit over several months. This chapter details the use of BoNT for ischemic digits caused by Raynaud’s phenomenon, including injection technique, dosing and quantification of perfusion and oxygenation using laser Doppler.