Botulinum toxin injection for Cockayne syndrome with muscle spasticity over bilateral lower limbs: A case report

Lin Chieh Hsu, Po Ying Chiang, Wei Pin Lin, Yao Hong Guo, Pei Chun Hsieh, Ta Shen Kuan, Wei Chih Lien, Yu Ching Lin

Research output: Contribution to journalArticlepeer-review


BACKGROUND Cockayne syndrome (CS) is a rare inherited disease characterized by progressive motor symptoms including muscle weakness, joint contracture, ataxia, and spasticity. Botulinum neurotoxin type A has been used for conditions such as dystonia and spasticity, but it has rarely been used in patients with CS. CASE SUMMARY We report a 6-year-and-9-mo old girl diagnosed with CS who received an injection of botulinum neurotoxin type A to manage her difficulty with walking. A total dose of 210 units of botulinum neurotoxin type A was administered into the bilateral tibialis posterior and gastrocnemius muscles. To evaluate the treatment effects on spasticity, joint contracture, pain, and ataxia, measurement tools including the Modified Ashworth Scale, the passive range of motion, the Faces Pain Scale-Revised, and the Scale for the Assessment and Rating of Ataxia, were employed. The first week after the injection, the Modified Ashworth Scale score for the plantar flexors and foot invertors improved bilaterally, along with advancements in the passive range of motion of the bilateral ankles and a lower score for the Faces Pain Scale-Revised. These treatment effects persisted to the 8th week post-injection, but returned to baseline values at the 12th week post-injection, except for the pain scale. CONCLUSION Botulinum toxin injection can thus be considered as a treatment option for lower extremity spasticity, joint contracture, and pain derived from CS.

Original languageEnglish
Pages (from-to)4728-4733
Number of pages6
JournalWorld Journal of Clinical Cases
Issue number18
Publication statusPublished - 2021 Jun 26

All Science Journal Classification (ASJC) codes

  • General Medicine


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