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Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. [24] It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction , thus causing flaccid paralysis . [ 25 ]
Treatment using botulinum toxin type B is comparable to type A, with an increased frequency of the side effect dry mouth. [ 10 ] [ 21 ] Common side effects include pain at the injection site (up to 28%), dysphagia due to the spread to adjacent muscles (11% to 40%), dry mouth (up to 33%), fatigue (up to 17%), and weakness of the injected or ...
Phenol injections can be used, or botulinum toxin [24] [18] [19] [25] injections into the muscle belly, to attempt to dampen the signals between nerve and muscle. The effectiveness of medications vary between individuals, and vary based on location of the upper motor neuron lesion (in the brain or the spinal cord).
Botulinum toxin is focal treatment, meaning that a limited number of muscles can be injected at the same time. The effect of the toxin is reversible and a reinjection may be needed every 4–6 months. [61] In children it decreases spasticity and improve range of motion and thus has become commonly used.
Drugs such as baclofen, benzodiazepines (e.g., diazepam), tizanidine, and sometimes dantrolene have shown promise in the effort to diminish spasticity. [10] Botulinum toxin ("Botox") type A may reduce spasticity a few months at a time and has frequently been considered a beneficial treatment for children with SHCP and other forms of CP. [5]
Injections of botulinum toxin increase the risk of visual complaints and ptosis (eyelid droop). [46] Patients who do not respond well to medication or botulinum toxin injections are candidates for surgical therapy. The most effective surgical treatment has been protractor myectomy, the removal of muscles responsible for eyelid closure. [49]
Hypertonia is a term sometimes used synonymously with spasticity and rigidity in the literature surrounding damage to the central nervous system, namely upper motor neuron lesions. [1] Impaired ability of damaged motor neurons to regulate descending pathways gives rise to disordered spinal reflexes , increased excitability of muscle spindles ...
Treatment of spastic gait may include physiotherapy, drugs that relax the muscles (including baclofen and tizanidine), and local botulinum toxin injections. [ 1 ] [ 2 ] References
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