Botulinum toxin in movement disorders.
Botulinum toxin inhibits the vesicular release of acetylcholine in the neuromuscular junction, resulting in a transient, localized paralysis when small doses are injected. The successful use of serotypes A and B in conditions with muscle overactivity such as dystonia and spasticity has been well established. Apart from approved indications, treatment with botulinum toxin injections is attempted in a variety of new areas of neurology, including tremor, tics, and myoclonus. This article provides an update on the uses of botulinum toxin in the field of movement disorders and draws special attention to theoretical and practical treatment issues of primary and secondary dystonic disorders. Long-term experience with this agent suggests that it is an effective and safe treatment not only for approved indications but also for the increasing number of off-label indications. However, controlled studies for many conditions are lacking, and more clinical trials in many different areas are warranted.
Papapetropoulos
Spiridon
S
Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
Singer
Carlos
C
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001764:Blepharospasm / Q000188:drug therapy; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004421:Dystonia / Q000188:drug therapy; D019569:Hemifacial Spasm / Q000188:drug therapy; D006801:Humans; D009069:Movement Disorders / Q000188:drug therapy*
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins