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European Journal of Physical and Rehabilitation Medicine 2015 June;51(3):345-9

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Botulinum toxin treatment of pes cavovarus in a child suffering from autosomal recessive axonal Charcot-Marie-Tooth neuropathy (AR-CMT2)

Tiffreau V. 1, Allart E. 1, Dangleterre C. 2, Boutry N. 3, Petit F. 4, Cuisset J. M. 5, Thevenon A. 1

1 Center for Neuromuscular Disorders, Department of Physical and Rehabilitation Medicine, Lille University Medical Centre and University of Lille Nord de France, Lille cedex, France; 2 Child Surgery Unit, Jeanne de Flandre Hospital, Lille University Medical Centre, Lille cedex, France; 3 Child Radiology Unit, Jeanne de Flandre Hospital, Lille University Medical Centre, Lille cedex, France; 4 Department of Clinical Genetics, Jeanne de Flandre Hospital, Lille University Medical Centre, Lille cedex, France; 5 Neuropaediatric Department, Salengro Hospital, Lille University Medical Centre, Lille cedex, France


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In a 12-year old girl suffering from autosomal recessive axonal Charcot-Marie-Tooth (CMT) neuropathy, pes cavovarus was treated with botulinum toxin injection in the tibialis posterior. The patient underwent a clinical evaluation, video analysis of spatiotemporal gait parameters and dynamic foot plantar pressure assessment before treatment and then two weeks, three months and six months thereafter. The video gait analysis revealed a decrease in varus during the swing phase of gait. The dynamic foot plantar pressure decreased by 50% in the excessive pressure at the side of the foot six months after the injection (maximal pressure=42.6N/cm2 before treatment and 18.9 N/cm2 after 6 month). Botulinum toxin injection appears to be an efficacious means of correcting pes cavovarus in CMT disease. A larger-scale clinical trial is now required to evaluate the putative longer-term preventive effect of this treatment on the pes cavus deformity.

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