What is Botulinum toxin?
There are many brands of botulinum toxin including ‘Botox’ and ‘Dysport’, all derived from the seven neurotoxins produced by strains of Clostridium botulinum bacteria.In particular two slightly different types, Botulinum toxin A and Botulinum toxin B are now in common use. These toxins acts on peripheral nerves supplying muscle fibres, permanently blocking the message to the muscle fibres and so preventing them from contracting.
They also work by blocking secretions from glands. However, the nerve can regrow or new nerves can develop so the treatment may only be effective for a few months before it has to be repeated.
Medical uses
Botulinum toxin therapy can be of use in a wide range of conditions where there is excessive muscular spasm, for example :- Cerebral palsy - where muscle spasm causes limb contractures.
- Cervical dystonia – a condition where neck muscle spasm affects head control.
- After a stroke - where there is limb spasticity.
- Upper motor Neurone syndrome - where muscles can be overactive.
- Blepharospasm and facial spasms - where there is uncontrollable blinking or spasm of other facial muscles.
- Squints (strabismus).
- Voicebox disorders (dysphonia).
- Anal fissures – tears which result from spasm of the anal muscle.
- Achalasia – where the oesophageal muscles wont relax.
- Severe hyperhidrosis (excessive sweating) of the armpits and hands .
- Severe drooling where the parotid glands of the sides of the face are producing too much saliva.
- Botulinum toxin injections to the head and neck have been approved for the treatment of chronic migraine although the exact mechanism of action is still not totally clear .
- It may have a future role in the management of diabetic neuropathy and also wound healing.
