Hitchhiker's Toe and Lumbar Disc Lesion: A Strange Coincidence in a Patient with Idiopathic Dystonia Treated with Botulinum Toxin Injection

Abstract

Abstract A 40 years old female with generalised dystonia and chronic low back pain was injected with botulinum toxin injection to extensor hallucis longus(EHL) for management of Hitchhiker's toe. The patient benefited functionally but later developed EHL and extensor digitorum (ED) weakness. Further workup revealed degenerative L4/5 disc lesion causing L5 root affection as the cause for the weakness. This coincidental occurrence of EHL and ED weakness due to L4/5 disc lesion in a patient with generalised dystonia, following botox injection to EHL for management of Hitch hiker's toe, has not been reported before.