Botulinum Toxin - Therapeutic Uses

Botulinum toxin is produced by the bacterium Clostridium botulinum, which is closely related to the organisms that cause gas gangrene and tetanus. It produces a total of seven different toxins all of which have the same end result, the paralysis of muscle. Ingestion of these toxins causes illness known as botulism, an often fatal paralytic disease which has been known for over 200 hundred years and became fully understood in 1897. Outbreaks of botulism still occur from time to time, particularly in the USA where home bottling and canning of foodstuffs is popular.

One of the toxins, Botulinum Neurotoxin Type A (BoNT/A), was first purified in 1946 and is now available for medical use under the trade names Botox (Allergan) and Dysport (Ipsen).

The first clinical use for BoNT/A was that of treating muscular spasms in the muscles around the eye. Extraordinarily small quantities of this very potent substance being injected directly into the target muscles, causes complete and long lasting paralysis of the overactive muscles. Success rates of over 85% drew wider attention to the drug and more and more applications were found, often with equally impressive success rates. BoNT/A is now the treatment choice for muscular spasms affecting the face, for torticollis (wry neck), and is widely used in the treatment of excessive muscle activity in those with cerebral palsy.

Often one use has led to another. When used for facial spasm it was found that areas prone to wrinkles, particularly around the eyes appeared smoother as the muscles of expression were paralysed, and this led to the development of its use in cosmetics. This in turn led to the discovery that some of those who received BoNT/A for cosmetic use often reported that migraines and chronic daily headaches, from which they had previously suffered, improved dramatically. Its use in the treatment of headaches led to the treatment of other painful conditions and so on.

Today the considerable majority of those who receive BoNT/A receive it for cosmetic reasons. It is primarily used to soften the expression lines between the eyes (the frown lines), the outer corners of the eyes (crows feet), and the brow lines. It has an exceptional safety record, particularly in cosmetics where the lowest doses are used. Its action lasts for three to six months and its use may delay considerably the formation of facial lines, if treatment is started before those become established.

There is an increasing trend to use BoNT/A in a wide range of conditions, teeth grinding and temporomandibular joint syndrome, writer's cramp and similar problems, tremors and tics, and excessive sweating in the palms and armpits. In the field of chronic pain a proportion of patients with simple low back pain often show dramatic improvement in symptoms, as do myofascial trigger points, muscular contractures and chronic post surgical pain.

As one American physician has observed;"Where you find a muscle, you will find a use for Botulinum Toxin!"

M K Kocan. 10/5/01.


	Botulinum Toxin - Therapeutic Uses Botulinum toxin is produced by the bacterium Clostridium botulinum, which is closely related to the organisms that cause gas gangrene and tetanus. It produces a total of seven different toxins all of which have the same end result, the paralysis of muscle. Ingestion of these toxins causes illness known as botulism, an often fatal paralytic disease which has been known for over 200 hundred years and became fully understood in 1897. Outbreaks of botulism still occur from time to time, particularly in the USA where home bottling and canning of foodstuffs is popular. One of the toxins, Botulinum Neurotoxin Type A (BoNT/A), was first purified in 1946 and is now available for medical use under the trade names Botox (Allergan) and Dysport (Ipsen). The first clinical use for BoNT/A was that of treating muscular spasms in the muscles around the eye. Extraordinarily small quantities of this very potent substance being injected directly into the target muscles, causes complete and long lasting paralysis of the overactive muscles. Success rates of over 85% drew wider attention to the drug and more and more applications were found, often with equally impressive success rates. BoNT/A is now the treatment choice for muscular spasms affecting the face, for torticollis (wry neck), and is widely used in the treatment of excessive muscle activity in those with cerebral palsy. Often one use has led to another. When used for facial spasm it was found that areas prone to wrinkles, particularly around the eyes appeared smoother as the muscles of expression were paralysed, and this led to the development of its use in cosmetics. This in turn led to the discovery that some of those who received BoNT/A for cosmetic use often reported that migraines and chronic daily headaches, from which they had previously suffered, improved dramatically. Its use in the treatment of headaches led to the treatment of other painful conditions and so on. Today the considerable majority of those who receive BoNT/A receive it for cosmetic reasons. It is primarily used to soften the expression lines between the eyes (the frown lines), the outer corners of the eyes (crows feet), and the brow lines. It has an exceptional safety record, particularly in cosmetics where the lowest doses are used. Its action lasts for three to six months and its use may delay considerably the formation of facial lines, if treatment is started before those become established. There is an increasing trend to use BoNT/A in a wide range of conditions, teeth grinding and temporomandibular joint syndrome, writer's cramp and similar problems, tremors and tics, and excessive sweating in the palms and armpits. In the field of chronic pain a proportion of patients with simple low back pain often show dramatic improvement in symptoms, as do myofascial trigger points, muscular contractures and chronic post surgical pain. As one American physician has observed;"Where you find a muscle, you will find a use for Botulinum Toxin!" M K Kocan. 10/5/01.
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