THE MEDICAL USES OF BOTULINUM TOXIN
TREATMENT WITH BOTULINUM TOXIN
- High patient acceptance compared to systemic medication
- Extremely effective in reducing excessive muscle tone and associated pain and deformity
- Benefits persists for months
- Facilitates rehabilitation goals, i.e., increased range of motion and hygiene
- Improves "quality of life" for patients and care-givers
- Effects are local and dose dependent; minimal effect to the rest of the body
- Can be used in conjunction with other therapies
BOTULINUM TOXIN OVERVIEW
Botulinum Toxin is produced by Clostridium Botulinum, which is a gram-positive anaerobic bacterium. The bacterium is in the shape of a rod. It was first discovered by Justinus Kerner the early 19th Century. The bacterium was found in water and soil and was identified with sausage poisoning. Kerner proposed that the poison produced by the bacteria may block the nervous system excitability.
Botulinum Toxin is a purified protein that comes from the bacterium, Clostridium botulinum. The two serotypes available in the United States are Botulinum Toxin A (Botox) and B (Myobloc). More recently, Dysport (abobotulinumtoxin A) has been introduced. The toxins are produced under strict quality control standards by both Allergan (Botox) and Solstice Neurosciences (Myobloc). The toxins should only be administered to patients by licensed doctors.
Botulinum Toxin works by stopping nerves from releasing acetylcholine, a substance that transits messages from nerves to muscles. When too much acetylcholine is released, muscles become overly active and tense up. With Botulinum Toxin muscle spasms may stop or be greatly reduced, resulting in relief. There is also evidence that the toxins may reduce neck pain in patients with cervical dystonia even before it achieves a significant muscle relaxation effect. After Botulinum Toxin treatment, many cervical dystonia patients experience up to three months of relief from muscle spasm. That is how long it takes the nerves to resume the release of acetylcholine. Muscles can be reinjected every three to four months with the toxin, as long as no allergic reactions or other significant side effects occured and the condition responded to treatment.