Lidocaine injections and neck corset wearing improve dropped head syndrome in Parkinson's disease and related disorders.
Dropped head
Lidocaine
Muscle afferent block
Parkinson's disease
Scalene muscle
Journal
Clinical parkinsonism & related disorders
ISSN: 2590-1125
Titre abrégé: Clin Park Relat Disord
Pays: England
ID NLM: 101761473
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
08
2019
revised:
15
10
2019
accepted:
20
10
2019
entrez:
28
7
2021
pubmed:
26
10
2019
medline:
26
10
2019
Statut:
epublish
Résumé
Patients with Parkinson's disease and related disorders (PDRD) may exhibit dropped head syndrome (DHS), which does not yet have an effective treatment. To evaluate the effect of combining lidocaine injection into the bilateral scalene muscles and neck corset wearing on dropped head syndrome. We performed needle electromyography assessments of the scalene, sternocleidomastoid (SCM), levator scapulae, splenius capitis, and trapezius muscles. Patients received 2.5-5 ml injections of 1% lidocaine into both sides of the scalene muscles for 4/5 consecutive days and were instructed to wear a neck corset. We measured the neck flexion angle, which formed between the horizontal line and the straight line passing through the ear canal and orbital fossa, before (baseline) and after (Day 8 and Day 90) the intervention. Seven males and eight females (mean age, 68.9 years; range 56 to 85 years) who had PDRD with dropped head syndrome were enrolled in this study. Needle electromyography examination revealed abnormal discharge of the scalene muscles in all patients when the neck position was corrected; however, some patients did not show abnormal discharge of the SCM muscle. At Day 8, we observed an improvement of the neck flexion angle in 13 of the 15 patients, from an average of 27.7° ± 13.9° to 11.7 ± 14.6°. At Day 90, the average neck flexion angle was 15.3° ± 17.2°. Combining lidocaine injection into the scalene muscles and neck corset wearing is an effective treatment regimen for DHS in patients with PDRD.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with Parkinson's disease and related disorders (PDRD) may exhibit dropped head syndrome (DHS), which does not yet have an effective treatment.
OBJECTIVES
OBJECTIVE
To evaluate the effect of combining lidocaine injection into the bilateral scalene muscles and neck corset wearing on dropped head syndrome.
METHODS
METHODS
We performed needle electromyography assessments of the scalene, sternocleidomastoid (SCM), levator scapulae, splenius capitis, and trapezius muscles. Patients received 2.5-5 ml injections of 1% lidocaine into both sides of the scalene muscles for 4/5 consecutive days and were instructed to wear a neck corset. We measured the neck flexion angle, which formed between the horizontal line and the straight line passing through the ear canal and orbital fossa, before (baseline) and after (Day 8 and Day 90) the intervention.
RESULTS
RESULTS
Seven males and eight females (mean age, 68.9 years; range 56 to 85 years) who had PDRD with dropped head syndrome were enrolled in this study. Needle electromyography examination revealed abnormal discharge of the scalene muscles in all patients when the neck position was corrected; however, some patients did not show abnormal discharge of the SCM muscle. At Day 8, we observed an improvement of the neck flexion angle in 13 of the 15 patients, from an average of 27.7° ± 13.9° to 11.7 ± 14.6°. At Day 90, the average neck flexion angle was 15.3° ± 17.2°.
CONCLUSIONS
CONCLUSIONS
Combining lidocaine injection into the scalene muscles and neck corset wearing is an effective treatment regimen for DHS in patients with PDRD.
Identifiants
pubmed: 34316606
doi: 10.1016/j.prdoa.2019.10.003
pii: S2590-1125(19)30026-X
pmc: PMC8288613
doi:
Types de publication
Journal Article
Langues
eng
Pagination
82-85Informations de copyright
© 2019 The Authors.
Déclaration de conflit d'intérêts
None.
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