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.