Repeated botulinum toxin injections for neurogenic thoracic outlet syndrome: A case report
Eren Aygun
, Deniz Palamar, Burak Ugur Cetin, Rana Terlemez, Kenan Akgun
Department of Physical Medicine and Rehabilitation, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
Keywords: Botulinum toxin A, thoracic outlet syndrome, ultrasound-guided injection.
Abstract
Neurogenic thoracic outlet syndrome (nTOS) is a condition caused by compression of the brachial plexus in the thoracic outlet, often leading to pain and paresthesia. In this article, we report a 34-year-old female patient with chronic nTOS symptoms refractory to prior management. Ultrasound-guided diagnostic blocks of the anterior scalene and pectoralis minor muscles provided significant temporary relief. Subsequent ultrasoundguided onabotulinum toxin A (BTX-A) injections into the scalene muscles resulted in near-complete symptom resolution lasting approximately six months. Over an 18-month follow-up, repeated injections at six-month intervals produced consistent clinical improvement without adverse effects. In conclusion, repeated ultrasound-guided BTX-A injections may be a safe and effective option within a multimodal treatment approach for nTOS.
Cite this article as: Aygun E, Palamar D, Cetin BU, Terlemez R, Akgun K. Repeated botulinum toxin injections for neurogenic thoracic outlet syndrome: A case report. Agri 2026;38(3):202-204. doi: 10.5606/agri.2026.43.
D.P., R.T., K.A.: Contributed to the idea and concept of the study, provided control and supervision throughout the study, critically reviewed the manuscript; D.P., R.T.: Were responsible for the study design; E.A., B.U.C.: Contributed to data collection and/or processing, analysis and/or interpretation of the data, literature review, writing of the manuscript, and preparation of references and funding-related sections. All authors read and approved the final version of the manuscript.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.
The authors received no financial support for the research and/or authorship of this article.
Data Sharing Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.