Spasticity

Botulinum Toxin: Historical Perspectives

Botulinum Toxin: Historical Perspectives and Potential New Indications
Joseph Jankovic, MD; MF Brin, MD
MF Brin, MD, editor
Muscle Nerve 1997; 20 (suppl 6): S129-S145.

Abstract: Botulinum toxin (BTX), a purified form of the neurotoxin responsible for botulism, is used worldwide for the treatment of abnormal muscle contractions. The ability of BTX to block acetylcholine release in a long-lasting but reversible fashion with few side effects has made it an important tool in a wide variety of neuromuscular disorders, including the dystonias, tremor, tics, and spasticity. There are seven antigenically distinct toxins. BTX-A has been in clinical use for almost two decades, with an outstanding efficacy and safety profile. Clinical effects are often seen within 1 week of injection, and benefits typically last from 3-6 months. Patient selection and the proper choice of dose and administration site are the most important determinants of a favorable response to BTX treatment.

©1997 John Wiley and Sons, Inc.

Key Points:

• There are seven antigenically distinct neurotoxins: A, B, C, D, E, F, and G


• BTX-A has FDA approval for strabismus, blepharospasm, and hemifacial spasm


• BTX is considered by many as the treatment of choice for blepharospasm, oromandibular dystonia, cervical dystonia, and spasmodic dysphonia, and provides marked relief of other focal dystonias and involuntary muscular contractions


• Proper choice of dose and administration site are the most important determinants of a favorable response to BTX treatment


• Clinical effects are seen within 1 week of injection. Benefits last 3-6 months

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