Neurology -- Correspondence for Liguori et al., 60 (10) 1705-1707

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Correspondence to:

BRIEF COMMUNICATIONS:
R. Liguori, V. Donadio, V. Di Stasi, C. Cianchi, and P. Montagna
Palmaris brevis spasm: An occupational syndrome
Neurology 2003; 60: 1705-1707 [Abstract] [Full text] [PDF]

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Palmaris brevis spasm: An occupational syndrome: Daniel Tarsy, Diana Apetaurova, Seward B. Rutkove (20 August 2003)

Palmaris brevis spasm: An occupational syndrome 20 August 2003

Daniel Tarsy,
Beth Israel Deaconess Medical Center
330 Brookline Ave, Boston, MA 02215,
Diana Apetaurova, Seward B. Rutkove
Send Correspondence to journal:
Re: Palmaris brevis spasm: An occupational syndrome

dtarsy{at}bidmc.harvard.edu Daniel Tarsy, et al.

We successfully treated a patient with PB spasm on two occasions with botulinum toxin. On a background of transient neck pain and radicular symptoms in both upper extremities and magnetic resonance imaging findings of spondylosis 4 years earlier, a 30-year-old woman presented with painless but bothersome right hypothenar muscle contractions. Needle EMG on three occasions over four years showed continuous bursts of motor unit activity in right PB occurring in a cyclical pattern with fluctuating amplitude. There was no evidence of denervation, myokymic discharges or fasciculation potentials. We injected botulinum toxin type A, 20 units, into right PB on two occasions with complete relief of spasm which lasted 7 and 6 months respectively. Similar but milder symptoms later appeared in the left hand which have not required treatment.
PB spasm is usually not intrusive and may not require treatment. [1] However, given the lack of response to surgery reported by Liguori et al, botulinum toxin should be considered in patients with disturbing symptoms.
References
1. Liguori R, Donadio V, Di Stasi V, Cianchi C, Montagna P. Palmaris brevis spasm. An occupational syndrome. Neurology 2003;60:1705-1707.
2. Satya-Murti S, Layzer RB. Hypothenar dimpling. Arch Neurol 1976;33:706-708.
3. Loron P, Bouche P, Marelle L, Gautier JC. Spasm or dimpling of the hypothenar eminence. Rev Neurol 1985;141:149-151.
4. Serratrice G, Azulay JP, Serratrice J, Pouget J. Palmaris brevis syndrome. J Neurol Neurosurg Psychiatry 1995;59:182-184.