Combining Pharmacological Therapy and Ultrasound-Guided Botulinum Toxin Injection Resulted in Clinical Improvement in Bilateral Arterial-Neurogenic Thoracic Outlet Syndrome: A Case Report.
Andrea Garau, Bruna Denotti, Valentina Garau, Sara Maria Pintus
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Abstract
Background: Thoracic outlet syndrome (TOS) results from compression of the brachial plexus and/or the subclavian vessels. Botulinum toxin (BTX) has been shown to be useful in TOS both as a predictor of surgical outcome and as a therapeutic option.
Case report: We present the case of a 21-year-old woman with a rare form of bilateral TOS with combined arterial and neurogenic involvement. After surgical treatment on the right side, the patient developed symptoms on the left side. We adopted a multimodal therapeutic approach that effectively reduced her symptoms and improved her quality of life.
Conclusions: Our case suggests that alleviating neurovascular compression with BTX, together with pharmacological agents that modulate pain pathways, may lead to clinical improvement, even in complex and poorly documented cases of TOS.
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