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A review of thoracic outlet syndrome and the possible role of botulinum toxin in the treatment of this syndrome.
[thoracic outlet syndrome]
The
objective
of
this
paper
is
to
discuss
the
classification
,
diagnosis
,
pathophysiology
and
management
of
Thoracic
outlet
syndrome
(
TOS
)
.
Thoracic
outlet
syndrome
(
TOS
)
is
a
complex
entity
that
is
characterized
by
different
neurovascular
signs
and
symptoms
involving
the
upper
limb
.
TOS
is
defined
as
upper
extremity
symptoms
due
to
compression
of
the
neurovascular
bundle
in
the
area
of
the
neck
just
above
the
first
rib
.
Compression
is
thought
to
occur
at
one
or
more
of
the
three
anatomical
compartments
:
the
interscalene
triangle
,
the
costoclavicular
space
and
the
retropectoralis
minor
spaces
.
The
clinical
presentation
can
include
both
neurogenic
and
vascular
symptoms
.
TOS
can
be
difficult
to
diagnose
because
there
is
no
standardized
objective
test
that
can
be
used
and
the
clinician
must
rely
on
history
and
several
positive
findings
on
physical
exam
.
The
medial
antebrachial
cutaneous
nerve
conduction
may
be
a
sensitive
way
to
detect
pathology
in
the
lower
trunks
of
the
brachial
plexus
which
is
promising
for
future
research
.
Treatment
options
continue
to
be
conservative
and
surgical
.
However
,
for
those
who
have
failed
physical
therapy
there
is
research
to
suggest
that
botulinum
toxin
may
help
with
symptom
relief
.
However
,
given
that
there
has
been
conflicting
evidence
,
further
research
is
required
using
randomized
controlled
trials
.
Diseases
Validation
Diseases presenting
"upper limb"
symptom
holt-oram syndrome
liposarcoma
neuralgic amyotrophy
proteus syndrome
thoracic outlet syndrome
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