Article

Botulinum toxin gives a local tone reduction by blocking neurotransmission
at the motor endplate (MEP). The importance of using MEP-targeted injections is
demonstrated in animal models and in a clinical human study. The goal of this
review is to present the available data on the localization of the MEP zone of
frequently injected muscles of the lower limb and to compare this with current
practice. METHOD: Current knowledge on the localization of the MEP zone is based
on some older histological studies, and for some of the more frequently injected
muscles also on more recent anatomical dissection. RESULTS: We find that for some
muscles the MEP zone can be more precisely demarcated, and for many other muscles
that its location is somewhat different than the currently injected areas in
clinical practice. Optimal injection sites are presented for gastrocnemius,
soleus, tibialis posterior, semitendinosus, semimembranosus, gracilis, biceps
femoris, rectus femoris, adductor longus, brevis and magnus, and psoas muscles.
INTERPRETATION: We propose optimal injection sites in relation to external
anatomical landmarks for the frequently injected muscles of the human lower limb
to facilitate the efficiency of botulinum toxin injections.
CI - (c) The Authors. Journal compilation (c) Mac Keith Press 2010.

Langue : ANGLAIS