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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 ]
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]
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).
The Mayo Clinic Cancer Center is one of the oldest NCI-designated cancer centers in the United States, having first been designated in 1973. [3] The main location of the Mayo Clinic is in Rochester, MN. Campuses in Arizona and Florida opened later and became part of the Mayo Clinic Cancer Center in 2003. [4] [5]
Along with some strains of Clostridium butyricum and Clostridium baratii, these bacteria all produce the toxin. [2] Botulinum toxin can cause botulism, a severe flaccid paralytic disease in humans and other animals, [3] and is the most potent toxin known to science, natural or synthetic, with a lethal dose of 1.3–2.1 ng/kg in humans. [4] [5]
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 ...
On the other hand, HSP is classified as complex when lower limb spasticity is combined with any additional neurological symptom. [citation needed] This classification is subjective and patients with complex HSPs are sometimes diagnosed as having cerebellar ataxia with spasticity, intellectual disability (with spasticity), or leukodystrophy. [7]