{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:10:18Z","timestamp":1756375818676,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A restrained motor vehicle accident victim suffered from delayed onset left pectoralis myospasms refractory to multiple treatments: behavioural, conservative, physical therapy, opiate, muscle relaxer and incomplete response to invasive pain management spinal blocks. After conduction of a literature review, several authors had noted the mechanism of \u03b1-\u03b3 loop dysfunction resulting in myospams, and also case studies which described painful postsurgical myospasms that were treated with neurectomy and\/or botulinum toxin A with successful results. The patient in this case underwent an initial lidocaine injection to observe response to treatment, followed by two treatments with botulinum toxin A treatment with subsequent resolution of symptoms. Successful therapy and previous research supports that botulinum toxin A can be an effective treatment for myospasms secondary to trauma-induced \u03b1-\u03b3 dysfunction, as suggested by the cellular pathophysiology.<\/jats:p>","DOI":"10.1136\/bcr-2012-008519","type":"journal-article","created":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T08:19:49Z","timestamp":1372407589000},"page":"bcr2012008519","source":"Crossref","is-referenced-by-count":0,"title":["Post-traumatic delayed onset pectoralis myospasm secondary to \u03b1-\u03b3 dysfunction"],"prefix":"10.1136","volume":"2013","author":[{"suffix":"II","given":"Dennis L","family":"Barnett","sequence":"first","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klinton","family":"McGhee","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bungee","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center, Tacoma, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,6,27]]},"reference":[{"key":"2025082802415941000_2013.jun27_1.bcr2012008519.1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/j.1749-6632.2010.05459.x","article-title":"Permanent reorganization of Ia afferent synapes on motorneurons after peripheral nerve injuries","volume":"2013","author":"Alvarez","year":"2010","journal-title":"Ann N Y Acad Sci"},{"key":"2025082802415941000_2013.jun27_1.bcr2012008519.2","unstructured":"Haines DE . 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