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Follow on Google News | AILESBURY MEDICAL: 'The uses of Botox in Neurology' by Dr. Patrick TreacyBotulinum toxin is a medication and a neurotoxic protein produced by the bacterium Clostridium botulinum. The terms Botox (Cosmetic), Vistabel, Dysport, Myobloc, Neurobloc and Xeomin are trade names
By: Ailesbury Media NEUROLOGY In 1949, Burgen et al discovered that botulinum toxin blocks neuromuscular transmission, so it not surprising that botulinum toxin found its first use in neurology. In 1973, Alan B Scott, MD, of Smith-Kettlewell Eye Research Institute used BTX-A in monkey experiments and for the first time in humans to treat strabismus in 1980. Since then Botox therapy has found its way into headache management, epilepsy, multiple sclerosis, Parkinson's disease, movement disorders, neuromuscular disorders, and neuro-immune disorders. (a) Treatment of Spasticity in Children with Cerebral Palsy Since its introduction in 1989, BTX-A has been used in neurological problems in children, including the treatment of spasticity in children with cerebral palsy. (Edgar TS. Clinical utility of botulinum toxin in the treatment of cerebral palsy: comprehensive review. J Child Neurol 2001;16:37-46.) (b) Treatment of Muscular Spasms Scott et al successfully used BTX-A to treat blepharospasm and strabismus in the early 1980’s. Blepharospasm is the involuntary forceful closure of the eyelids resulting initially in uncontrollable blinking and eventually the eyelids remain closed all the time and the patient becomes functionally blind. (Scott AB: Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Ophthalmol Soc. 1981; 79: 734) Jankovic et al later used it for focal dystonias, muscle spasms and spasticity, (Jankovic J, Schwartz K, Donovan DT: Botulinum toxin in the treatment of cranial-cervical dystonias and hemifacial spasm. J. Neurol. Neurosurg. Psychiatry. 1990;53: 633). The FDA approved BTX type A (Botox®, Allergan) for the treatment of strabismus, blepharospasm, and hemifacial spasm in 1989 and BTX-B (Myobloc™, Elan) for clinical use in cervical dystonia patients later. Hemifacial spasm causes sudden, simultaneous contraction of the muscles on one side of the face and it can occur several times a day. BTX-A is also used for spasmodic torticollis of the neck and oromandibular dystonia, which involves continuous, bilateral spasms of the face, jaw, neck, tongue, larynx, and in severe cases, the respiratory system. (c ) Treatment of spasmodic dysphonia and other speech problems Spasmodic dysphonia is a focal dystonia affecting the laryngeal musculature, most commonly treated with localized injections of botulinum toxin A (Botox). These injections temporarily weaken the muscles, thereby decreasing dystonic laryngeal muscle activity. Duration of weakness varies from patient to patient and often from injection to injection. Murray and Woodson suggested that behavioural voice therapy used in combination with Botox increases effectiveness and duration of Botox injection therapy. Botox has proven effective in alleviating symptoms and restoring speech fluency, although one kind of spasmodic dysphonia (Abductor Spasmodic dysphonia) poses an airway obstruction risk if certain muscles are injected. Stuttering and vocal tremor may also be treatable with Botox. Most common disorders resulting in dysphonia include Parkinson disease, essential tremor (ET), and spasmodic dysphonia (SD). Unfortunately, there is little literature concerning the efficacy of voice therapy with other neurological disorders. # # # Ailesbury Clinics Ltd is the leading provider of advanced medical aesthetic skin care in Ireland. It was awarded Best Medical Practice in Ireland 2005. Further details WEBSITE http://www.ailesburyclinic.ie PHONE +3531 2692255/ 2133 Fax 2692250 End
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