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Severe constipation in Parkinson's disease relieved by botulinum toxin
A Albanese1, G Maria, A R Bentivoglio
1Institute of Neurology, Sacro Cuore Catholic University, Rome, Italy.
Movement Disorders : Official Journal of the Movement Disorder Society
|September 26, 1997
Summary
Botulinum toxin injections effectively treated severe outlet-type constipation in a Parkinson's disease patient. This treatment improved anorectal function and evacuation for about 12 weeks.
Area of Science:
- Gastroenterology
- Neurology
- Pharmacology
Background:
- Parkinson's disease frequently causes severe gastrointestinal dysfunction, particularly outlet-type constipation.
- Outlet-type constipation in Parkinson's disease is often refractory to conventional treatments.
Observation:
- A single patient with Parkinson's disease and severe outlet-type constipation received botulinum toxin (Botox) injections into the puborectalis muscle.
- The treatment involved 30 units of botulinum toxin administered at two sites.
Findings:
- Post-injection, significant reductions in resting anal pressure, maximum voluntary contraction, and straining pressure were observed.
- Proctography at 8 weeks revealed improved anorectal angle and enhanced barium paste evacuation.
- Clinical benefits, including improved constipation, persisted for approximately 12 weeks.
Implications:
- Botulinum toxin shows promise as a therapeutic option for managing outlet-type constipation in Parkinson's disease patients.
- This minimally invasive approach may offer a novel treatment strategy for refractory constipation in this population.
- Further research is warranted to confirm efficacy and safety in larger cohorts.