{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T04:24:24Z","timestamp":1768796664912,"version":"3.49.0"},"reference-count":12,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:p>INTRODUCTION: Sleep disorders presenting involuntary movements may be very annoying to patients, apart from their negative influence on sleep. OBJECTIVE: To report the use of botulinum type-A toxin (BoNT-A) to manage the case of a patient whose sleep was severely disrupted by episodes of dystonic posturing of the right lower limb triggered by periodic limb movements of sleep (PLMS). METHOD: A 79-year-old woman with mild post-stroke right hemiparesis presented with recurrent painful episodes of dystonia of the right lower limb, which disrupted her sleep. The dystonic episodes could also be voluntarily triggered by extension of the right hallux. Polysomnography confirmed that the dystonic episodes were triggered by PLMS. Twenty units of BoNT-A (20U\/500U vial) were injected into her right extensor hallucis longus. RESULTS: Shortly after BoNT-A was injected, the dystonic symptoms abated, and the patient achieved better sleep efficiency. CONCLUSION: The PLMS-related involuntary extension of the hallux was probably triggering the nocturnal post-stroke lower limb dystonic paroxysms. BoNT-A injection into the right extensor hallucis longus was effective in managing this condition and thus resolved the associated disruption of sleep.<\/jats:p>","DOI":"10.1590\/s0004-282x2006000600028","type":"journal-article","created":{"date-parts":[[2007,1,17]],"date-time":"2007-01-17T11:46:52Z","timestamp":1169034412000},"page":"1027-1029","source":"Crossref","is-referenced-by-count":5,"title":["Botulinum-A toxin in the treatment of painful post-stroke nocturnal paroxysmal dystonia triggered by periodic limb movements of sleep: case report"],"prefix":"10.1590","volume":"64","author":[{"given":"Pedro A.","family":"Kowacs","sequence":"first","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9lio A. Ghizoni","family":"Teive","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elcio J.","family":"Piovesan","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge A.","family":"Zavala","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lineu C.","family":"Werneck","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"S68","article-title":"Periodic, aperiodic, and rhythmic motor disorders of sleep","volume":"42","author":"Dyken ME","year":"1992","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref2","first-page":"594","article-title":"Effects of apomorphine on flexor reflex and periodic limb movement","volume":"17","author":"Paradiso G","year":"2002","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1053\/smrv.2001.0193","article-title":"Clinical symptomatology and treatment of restless legs syndrome and periodic limb movement disorder","volume":"6","author":"Stiasny K","year":"2002","journal-title":"Sleep Med Rev"},{"key":"ref4","series-title":"A manual of standardised terminology, techniques and scoring system for sleep stages of human subjects","author":"Rechtschaffen A","year":"1968"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/sleep\/8.3.239","article-title":"Relationship of periodic movements in sleep (nocturnal myoclonus) and the Babinski sign","volume":"8","author":"Smith RC","year":"1985","journal-title":"Sleep","ISSN":"https:\/\/id.crossref.org\/issn\/0161-8105","issn-type":"print"},{"key":"ref6","first-page":"719","article-title":"Sleep-related periodic leg movements associated with spinal cord lesions","volume":"11","author":"Lee MS","year":"1996","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1161\/01.STR.17.6.1319","article-title":"Painful tonic spasms caused by putaminal infarction","volume":"17","author":"Merchut MP","year":"1986","journal-title":"Stroke","ISSN":"https:\/\/id.crossref.org\/issn\/0039-2499","issn-type":"print"},{"key":"ref8","first-page":"234","article-title":"Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry","volume":"152","author":"Ghika-Schmid F","year":"1997","journal-title":"J Neurol Sci","ISSN":"https:\/\/id.crossref.org\/issn\/0022-510X","issn-type":"print"},{"key":"ref9","first-page":"13","article-title":"The syndrome of painful legs and moving toes","volume":"9","author":"Dressler D","year":"1994","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s11910-001-0087-6","article-title":"Focal dystonia: the role of botulinum toxin","volume":"1","author":"Tintner R","year":"2001","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref11","first-page":"881","article-title":"A case of post-hemiplegic painful dystonia following thalamic infarction with good response to botulinus toxin","volume":"37","author":"Motoi Y","year":"1997","journal-title":"Rinsho Shinkeigaku","ISSN":"https:\/\/id.crossref.org\/issn\/0009-918X","issn-type":"print"},{"key":"ref12","first-page":"281","article-title":"Post stroke hemiplegia: lower limb benefit from botulinum toxin","volume":"46","author":"Yelnik AP","year":"2003","journal-title":"Ann Readapt Med Phys","ISSN":"https:\/\/id.crossref.org\/issn\/0168-6054","issn-type":"print"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/anp\/v64n4\/a28v64n4.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T16:38:38Z","timestamp":1556037518000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-282X2006000600028&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,12]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2006,12]]}},"alternative-id":["S0004-282X2006000600028"],"URL":"https:\/\/doi.org\/10.1590\/s0004-282x2006000600028","relation":{},"ISSN":["0004-282X"],"issn-type":[{"value":"0004-282X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,12]]}}}