Objective: Camptocormia (CC) is one of the abnormal posture of Parkinson’s disease (PD) patients, described as a severe forward flexion of the trunk. In this study, We investigated the effect of repeated lidocaine injection into the external oblique muscle and rehabilitation. In addition, we also examined a change of lateral flexion angle in CC patients with the trunk lateral slant.

Background: Postural abnormality is a common finding in the long clinical course of Parkinsons disease. Postural abnormality include dropped head, anteflexion including camptocormia and lateroflexion. These changes may appear independently or combined. Usually these changes are hard to treat, except some cases which was beginning just after introduce of dopamine agonist. Considering the postural abnormality as a trunk dystonia, there are attempts to improve by direct treatment to responsible muscles.Furusawa and colleges have classified camptocormia into upper and lower types based on the inflection point, and reported that lidocaine injection into the external oblique muscle improved upper camptocormia in PD.

Methods: The study subjects were 20 PD patients with CC (as for seven cases with the lateral slant posture). We treated 10 ml lidocaine to each external oblique muscle once a day, consecutively for five days. A rehabilitation was done within one hour after the injection. The effect of treatment was evaluated by measuring the angle of truncal flexion before and after the injection of all cases, and one month later of a case.

Results: The truncal flexion angle showed improvement in 18 out of 20 cases in before and after injection, and the mean angle significantly decreased from 55.8 deg to 40.5 deg (p<0.01). The lateral flexion angle showed improvement in 6 out of 7 cases, the mean angle decreased significantly from 19.1 deg to 12.1 deg (p<0.01). In addition, we tended to maintain the effect for one month.

Conclusions: Our results showed that lidocaine injection into the external oblique muscle followed rehabilitation improved CC. In addition, to the improvement of the truncal flexion angle, we also found improvement of lateral flexion angle in the patients with the trunk lateral slant and the effectiveness to lateral slant posture was suggested.

References: Furusawa Y et al. Long-term effect of repeated lidocaine injections into the external oblique for upper camptocormia in Parkinson’s disease. Parkinsonism Relat Disord. 2013 19(3):350-4.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-lidocaine-injection-into-the-external-oblique-muscle-on-camptocormia-and-the-lateral-slant-posture-in-patient-with-parkinsons-disease/