title: Review of the FDA-approved uses of botulinum toxins, including data suggesting efficacy in pain reduction.
abstract: Botulinum toxin has dramatically improved the treatment of a variety of neurologic disorders. Two botulinum toxin preparations are commercially available in the United States: type A (Botox) and type B (Myobloc). Current indications approved by the United States Food and Drug Administration include cervical dystonia, strabismus, blepharospasm, hemifacial spasm, and glabellar wrinkles for Botox, and cervical dystonia for Myobloc. Botulinum toxin inhibits release of acetylcholine from the neuromuscular junction, resulting in a localized paralysis when minute doses are injected. This mechanism enables botulinum toxin to alleviate symptoms of focal dystonias (which are characterized by excessive muscle contraction), and it may also, along with other theoretical mechanisms, be responsible for pain relief. Studies conducted in patients with cervical dystonia have shown that botulinum toxin effectively reduces pain associated with this disorder, suggesting that this agent may be effective in alleviating other painful syndromes.
authors.affiliation: Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. mlew@surgery.usc.edu
authors.forename: Mark F
authors.initials: MF
authors.lastname: Lew
mesh_terms: D001764:Blepharospasm / Q000188:drug therapy*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D017277:Drug Approval; D019569:Hemifacial Spasm / Q000188:drug therapy; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D013285:Strabismus / Q000188:drug therapy; D014103:Torticollis / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome; D014481:United States
chemical_list: C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A