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Sample records for botulinum toxin injections

  1. Botulinum toxin injection - larynx

    Science.gov (United States)

    Injection laryngoplasty; Botox-larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography-guided botulinum toxin treatment; Percutaneous indirect laryngoscopy-guided botulinum toxin Treatment; ...

  2. Botulinum toxin.

    OpenAIRE

    Savardekar Preeti

    1989-01-01

    Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C 1 , C 2 , D, E, F and G). All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about...

  3. Ultrasound-guided botulinum toxin injections

    Directory of Open Access Journals (Sweden)

    S. E. Khatkova

    2016-01-01

    Full Text Available One of the key conditions for achieving the desirable result during botulinum toxin therapy for muscular dystonia, spasticity, and other diseases accompanied by spasm, pain, and autonomic dysfunction (dystonias, spasticity, etc. is the proper administration of the agent into the muscles directly involved in the pathological process. The exact entry of botulinum toxin into the target muscles is essential for successful and safe treatment because its injection into a normal muscle may cause side effects. The most common errors are the incorrect depth and incorrect direction of a needle on insertion. Therefore, the exact injection of the agent particularly into the shallow and deep muscles is a difficult task even for an experienced specialist and requires the use of controlling methods.The European Consensus on Botulinum Toxin Therapy points out that various injection techniques are needed for the better identification of necessary muscles. However, there are currently no reports on the clear advantage of any technique. In our country, injections using palpation and anatomical landmarks have been widely used in routine practice so far; electromyographic monitoring and electrostimulation have been less frequently applied. In recent years, the new method ultrasound-guided injection has continued to grow more popular. This effective, accessible, and easy-to-use method makes it possible to manage a real-time injection process and to ensure the exact entry of the agent into the muscle. This paper is dedicated to a comparative analysis of different injection methods and to a description of the ultrasound-guided technique and its advantages over others. 

  4. Botox (Botulinum Toxin)

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Botox (Botulinum Toxin) A A A BEFORE: Crow's feet before Botox ... wrinkles. One such procedure involves the use of botulinum toxin injections. Botulinum toxin is produced by the fermentation ...

  5. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance. During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization. The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  6. Botulinum Toxin Injections: A Treatment for Muscle Spasms

    Science.gov (United States)

    ... A Treatment for Muscle Spasms What is botulinum toxin? Botulinum toxin is a protein that helps stop muscle ... won't have any harmful effects from the toxin. Botulinum toxin has been used safely for a number ...

  7. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke

    OpenAIRE

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-01-01

    Abstract Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases. This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapeziu...

  8. Botulinum toxin

    Directory of Open Access Journals (Sweden)

    Nigam P

    2010-01-01

    Full Text Available Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C 1 , C 2 , D, E, F and G. All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about three months. Botulinum toxins now play a very significant role in the management of a wide variety of medical conditions, especially strabismus and focal dystonias, hemifacial spasm, and various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond only partially to medical treatment. The list of possible new indications is rapidly expanding. The cosmetological applications include correction of lines, creases and wrinkling all over the face, chin, neck, and chest to dermatological applications such as hyperhidrosis. Injections with botulinum toxin are generally well tolerated and side effects are few. A precise knowledge and understanding of the functional anatomy of the mimetic muscles is absolutely necessary to correctly use botulinum toxins in clinical practice.

  9. Acute angle-closure glaucoma following botulinum toxin injection for blepharospasm.

    OpenAIRE

    Corridan, P.; Nightingale, S; Mashoudi, N.; Williams, A C

    1990-01-01

    Botulinum toxin inhibits acetylcholine release and therefore could cause mydriasis. We report a case of acute angle-closure glaucoma which occurred shortly after a series of injections of botulinum toxin round the eyelids for blepharospasm.

  10. Remote Effects of Local Injection of Botulinum Toxin Type A

    Institute of Scientific and Technical Information of China (English)

    Wan Xinhua; Tang Xiaofu; Cui Liying

    2000-01-01

    Objective To assess the seventy and temporal profile of remote effects of botulinum toin type A, BTX-A (Botox from Allergan Inc.,USA and CBTX-A made by Lanzhou Biological Products Institute, China ) injected locally on neuromuscular transmission. Background Recently the local injection of BTX-A has been accepted as a breakthrough in the treatment of a variety of spasmodic disorders, and remote effects of BTX-A on the neuromuscular transmission are concemed. Methods Fourty patients who had enrolled in a prospective open study with Botox or CBTX-A for their movement disorders were studied, 18 cases with Botox and 22 cases with CBTX-A. SFEMG in the extensor digitorum communis muscle or tibialis anterior muscle was performed before and 2-3weeks, 5-8weeks, 4-5 months after injection of Botox or CBTX-A, totally 119 times. Results The significant increase of jitter was demonstrated 2-3weeks after injections in both groups and MCD was in direct proportion to dose of injections.Fiber density value increased at the same time or later and still existed until 4-5 months after injections. Conclusion There are subclinical effects on neuromuscular transmission of remote uninjected muscles after injections of Botox and CBTX A, which indicates that the toxin spread remotely from the site of injection.

  11. Botulinum Toxin Injection for Spastic Scapular Dyskinesia After Stroke: Case Series.

    Science.gov (United States)

    Hou, Saiyun; Ivanhoe, Cindy; Li, Sheng

    2015-08-01

    Spastic scapular dyskinesia after stroke is rare, which causes impaired shoulder active range of motion (ROM). To date, there has been no report about botulinum toxin injection to spastic periscapular muscles. This study presents botulinum toxin A injection for management of spastic periscapular muscles after stroke in 2 cases.This is a retrospective study of 2 cases of spastic scapular dyskinesia after stroke. Spasticity of periscapular muscles including rhomboid and lower trapezius was diagnosed by physical examination and needle electromyographic study. Botulinum toxin was injected into the spastic periscapular muscles under ultrasound imaging guidance.During the 3-week follow-up visit after injection, both patients showed increased shoulder active ROM, without any sign of scapular destabilization.The results suggest that botulinum toxin injection to spastic periscapular muscles can increase shoulder active ROM without causing scapular destabilization in patients with poststroke spastic scapular dyskinesia. PMID:26266368

  12. Botulinum toxin injection improved voluntary motor control in selected patients with post-stroke spasticity

    Institute of Scientific and Technical Information of China (English)

    Shuo-Hsiu Chang; Gerald E Francisco; Sheng Li

    2012-01-01

    The effect of botulinum toxin type A injection on voluntary grip control was examined in a 53-year-old female, who sustained a hemorrhagic right middle cerebral artery stroke 3 years previously, which resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injection each to the motor points (2 sites/muscle) of the left flexor digitorum superficialis and flexor digitorum profundus, respectively. Botulinum toxin injection led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor electromyography activity, and improved release time likely correlated with blocked co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.

  13. Intramural injection with botulinum toxin significantly elongates the pig esophagus

    DEFF Research Database (Denmark)

    Larsen, Heidi Fhær; Jensen, Thorbjørn Søren Rønn; Rasmussen, Lars;

    2013-01-01

    Surgical treatment of long-gap esophageal atresia (LGEA) is challenging. Methods which facilitate stretching of the esophageal pouches may allow primary anastomosis. Botulinum toxin type A (BTX-A) blocks acetylcholine release in neuromuscular junctions, thereby causing muscle relaxation. We hypot...

  14. Distribution of the Toxin following Medial Rectus Muscular Injection of Botulinum Toxin Gel in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Jingchang Chen; Guanghuan Mai; Xinping Yu; Huanyuan Yu; Heping Wu; Xiaoming Lin; Daming Deng; Ying Kang

    2005-01-01

    Purpose: To determine the distribution of the toxin among individual muscles after intramuscular injection of botulinum toxin gel.Methods: One eye of 7 New Zealand white rabbits was randomized into group A, and the contralateral eye was into group B. Eyes in group A received medial rectus intramuscular injection of 2.5 IU of 125I-BTX-A gel in 0.1 ml, and those in group B received equivalent amount of 125I-BTX-A solution by medial rectus intramuscular injection. Four rectus muscles and the levator palpebrae superioris were harvested and the radioactivity of muscles was measured 16 hours after the injection.Results: In group A, the radioactivity of per gram medial rectus was significantly higher than that of other muscles (P < 0.01), and there was no statistically significant difference in the radioactivity of per gram muscles among other muscles (P > 0.05). In group B, the radioactivity of per gram medial rectus and levator palpebrae superioris was significantly higher than that of other muscles respectively(P < 0.05), and the difference in the radioactivity of per gram muscles between medial rectus and levator palpebrae superioris was not statistically significant (P > 0.05). The radioactivity of per gram medial rectus in group A was higher than that in group B (t=3.731 ,P=0.01), and there was no significant difference in the radioactivity of per gram muscles among other homonymous muscles (P > 0.05).Conclusion: The toxin dispersed principally in the injected muscle and the local concentration of the toxin was much high following intramuscular injection of botulinum toxin gel.

  15. Assessment of intralesional injection of botulinum toxin type A injection for hypertrophic scars

    Directory of Open Access Journals (Sweden)

    Alhasan M Elhefnawy

    2016-01-01

    Full Text Available Background: Hypertrophic scars are dermal fibroproliferative disorders that typically develop after a skin injury heals. They can cause physical, psychological, and cosmetic problems. The management of such scars remains a matter of debate due to lack of effective treatment methods and the inability to prevent recurrences. Recent reports have demonstrated that botulinum toxin type A improves wound healing so it may play a role in treating hypertrophic scars. Aims: We assessed the effectiveness of intralesional botulinum toxin type A injection for treating hypertrophic scars. Methods: This prospective clinical study included twenty patients with hypertrophic scars. Intralesional injection of botulinum toxin type A was given once a month for three months with a follow-up period of six months. Each lesion was injected until slight blanching occurred. Therapeutic satisfaction of the patient and physician were recorded. Lesions were assessed for erythema, itching and pliability. Each item was assessed on a 5-point scale. Results: Therapeutic satisfaction was recorded as 'good' in 14 patients and 'excellent' in the remaining six. The mean erythema score decreased from 3.2 to 1.0, the mean pliability score from 3.3 to 0.8 and the mean itching score from 2.7 to 0.7. All of these were statistically significant. Limitations: A larger sample size and longer follow-up period would have given a better evaluation but was not feasible due to the high expenses involved. Conclusion: Botulinum toxin type A is a novel and promising therapy for hypertrophic scars with few side effects.

  16. Unilateral transient mydriasis and ptosis after botulinum toxin injection for a cosmetic procedure

    Directory of Open Access Journals (Sweden)

    Akkaya S

    2015-02-01

    Full Text Available Sezen Akkaya,1 Hatice Kübra Kökcen,1 Tuğba Atakan2 1Fatih Sultan Mehmet Education and Training Hospital, Ophthalmology Clinics, Bostanci, Istanbul, 2Aksaray Hospital, Ophthalmology Clinics, Konya, Turkey Abstract: We report a case of unilateral transient mydriasis and ptosis after botulinum toxin injection applied by a medical doctor for a cosmetic procedure. A 36-year-old nurse was referred to our eye clinic with unilateral mydriasis and ptosis in the right eye 3 days after botulinum toxin injection for a cosmetic procedure. Botulinum toxin was applied to her eye by a doctor at her hospital who was not an ophthalmologist. She was treated with topical apraclonidine 0.5% ophthalmic solution. Her ptosis decreased to 2 mm with apraclonidine and her visual axis improved. Mydriasis was present for 3 weeks and then disappeared. Mild ptosis continued for 3 months, then resolved completely. Patients seeking treatment with botulinum toxin A for cosmetic purposes should be warned about the possibility of ptosis and mydriasis after injection. If these side effects are seen, the patient must be referred to an ophthalmologist for appropriate management. Keywords: botulinum toxin, mydriasis, ptosis

  17. Sustained improvement of reading symptoms following botulinum toxin A injection for convergence insufficiency

    DEFF Research Database (Denmark)

    Saunte, Jon Peiter; Holmes, Jonathan M

    2014-01-01

    INTRODUCTION: We evaluated the use of botulinum toxin A in adults with convergence insufficiency in whom prior treatment had failed. METHODS: We studied 8 patients (median age 36 years, range 17 to 77 years) with reading symptoms due to convergence insufficiency defined as an exodeviation greater...... (n=2). Five patients received injection of 5 IU botulinum toxin in 0.1 ml saline to one lateral rectus muscle, two received 2.5 IU, and one received 2.5 IU to both lateral rectus muscles. RESULTS: At 1 month post injection, all patients had an initial reduction of exodeviation from baseline (median 9...... PD, p=0.008) at near, although 2 patients had a temporary intermittent esotropia in the distance with diplopia associated with difficulty driving. At 6 months, when the pharmacological effect of botulinum toxin had completely worn off, patients still maintained a small reduction of exodeviation...

  18. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    Directory of Open Access Journals (Sweden)

    Michael P Cannito

    2008-03-01

    Full Text Available Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.Keywords: vocal aging, adductor spasmodic dysphonia, botulinum toxin, voice quality, speech fluency

  19. Efficacy of Botulinum Toxin Injections in the Treatment of Various Types of Facial Region Disorders

    Directory of Open Access Journals (Sweden)

    Arzu Çoban

    2012-12-01

    Full Text Available OBJECTIVE: Local injection of botulinum toxin is a highly effective treatment option for a wide range of movement disorders and there are reliable sources of information on its indications, effects and safety in clinical practice. In this study, we report our experience with botulinum toxin in the treatment of facial region disorders. METHODS: Patients who had been followed in the Botulinum Toxin Outpatient Clinic of the Neurology Department were retrospectively evaluated. Two preparations of botulinum toxin type A (BT-A were used. The efficacy of BT-A injections was rated according to the improvement in symptoms as follows: marked - 75-100% improvement, good - 50-74%, moderate - 25-49%, and insufficient - less than 25% symptom relief. RESULTS: One hundred eighty-two patients (73 male, 109 female with various facial region disorders were included. The efficacy rates for patients who had very good and good improvement were high in the treatment of blepharospasm, hemifacial spasm, facial synkinesis, and Meige syndrome and moderate for oromandibular dystonia and hypersalivation. Ptosis was the most common side effect. CONCLUSION: According to our results, botulinum toxin was very effective treatment for blepharospasm, Meige syndrome, hemifacial spasm and facial synkinesis, whereas it demonstrated good efficacy in oromandibular dystonia and hypersalivation.

  20. Botulinum toxin injections to reduce adiposity: possibility, or fat chance?

    Science.gov (United States)

    Lim, Erle C H; Seet, Raymond C S

    2006-01-01

    Obese individuals often suffer from negative self-image. Many, even those with a normal body mass index, resort to pharmacotherapy (lipase inhibitors or appetite suppressants), mesotherapy and surgery (gastric volume reduction, liposuction or apronectomy) in a bid to remove excess adipose tissue. These treatments are associated with inherent morbidity and even mortality, and hence should not be undertaken lightly. The observation that denervation of adipose tissue results in lipoatrophy leads us to postulate that chemodenervation using botulinum toxin may achieve the same result, i.e. fat loss, and we explore the methods by which selective fat loss may be achieved. We concede that removal of subcutaneous fat does not, however, reduce the risks associated with the metabolic syndrome, as visceral (intra-abdominal) fat is not reduced by the removal of subcutaneous fat. PMID:16716533

  1. Effect of a clown's presence at botulinum toxin injections in children: a randomized, prospective study

    DEFF Research Database (Denmark)

    Hansen, Lars Kjaersgaard; Kibaek, Maria; Martinussen, Torben;

    2011-01-01

    The effect of the presence of a hospital clown during pediatric procedures has rarely been evaluated. In a pediatric ward, botulinum toxin injection is a painful procedure and a stressful experience for the child. We undertook a study of the effect of the presence of a hospital clown on children...

  2. Multipoint and multilevel injection technique of botulinum toxin A in facial aesthetics.

    Science.gov (United States)

    Iozzo, Ivano; Tengattini, Vera; Antonucci, Valentina A

    2014-06-01

    Botulinum toxin represents one of the most frequently requested cosmetic procedures. We treated 223 patients with facial wrinkles using a new technique of injection of botulinum toxin A (BTA) called multipoint and multilevel injection technique (MMIT). The aim of MMIT was to relax the muscle and not paralyze it. Patient satisfaction was evaluated by Facial Line Treatment Satisfaction Questionnaire (FTSQ). Treatment with botulinum toxin determined a good response in all patients. Facial rhytids were completely resolved in case of young skin and well reduced in case of aged skin, leaving a natural aspect both in static and dynamic wrinkles. Patient mean overall satisfaction evaluated with FTSQ was 6.4 ± 1.1. In our experience, the use of botulin toxin by MMIT consents a better calibration of action with a soft and natural result. This can be achieved by distributing the BTA dose through various injection points for each area ("multipoint injections"). Furthermore, injections can be performed at different levels ("multilevel injections"). The level of injections regulates the potency of effect on the muscle: if the level is deep (intramuscular), the effect will be strong while if it is medium or superficial (subcutaneous and intradermal), the effect will be soft. This consents a fine calibration of action on muscle activity with a personal aesthetic result.

  3. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    Directory of Open Access Journals (Sweden)

    Jae Wook Kim

    2014-01-01

    Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

  4. Botulinum toxin injection techniques for the management of adult spasticity.

    Science.gov (United States)

    Walker, Heather W; Lee, Michael Y; Bahroo, Laxman B; Hedera, Peter; Charles, David

    2015-04-01

    Spasticity is often experienced by individuals with injury or illness of the central nervous system from etiologies such as stroke, spinal cord injury, brain injury, multiple sclerosis, or other neurologic conditions. Although spasticity may provide benefits in some patients, it more often leads to complications negatively impacting the patient. Nonpharmacologic treatment options often do not provide long-term reduction of spasticity, and systemic interventions, such as oral medications, can have intolerable side effects. The use of botulinum neurotoxin injections is one option for management of focal spasticity. Several localization techniques are available to physicians that allow for identification of the selected target muscles. These methods include anatomic localization in isolation or in conjunction with electromyography guidance, electrical stimulation guidance, or ultrasound guidance. This article will focus on further description of each of these techniques in relation to the treatment of adult spasticity and will discuss the advantages and disadvantages of each technique, as well as review the literature comparing the techniques. PMID:25305369

  5. [Intoxication of botulinum toxin].

    Science.gov (United States)

    Chudzicka, Aleksandra

    2015-09-01

    Botulinum toxin is an egzotoxin produced by Gram positive bacteria Clostridium botulinum. It is among the most potent toxins known. The 3 main clinical presentations of botulism are as follows: foodborne botulism, infant botulism and wound botulism. The main symptom of intoxication is flat muscles paralysis. The treatment is supportive care and administration of antitoxin. In prevention the correct preparing of canned food is most important. Botulinum toxin is accepted as a biological weapon.

  6. Botulinum toxin injection for bruxism associated with brain injury: Case report

    Directory of Open Access Journals (Sweden)

    Serdar Kesikburun, MD

    2014-07-01

    Full Text Available Bruxism is involuntary grinding of the teeth and can occur as a complication of brain injury. If untreated, bruxism can lead to severe occlusal trauma. Herein, we present a patient with traumatic brain injury and nocturnal bruxism that was treated with botulinum toxin injection. A 21 yr old male patient with traumatic brain injury from a car accident was admitted to our inpatient rehabilitation unit. He had a history of coma for 2 wk in the intensive care unit. The initial cranial computed tomography scan indicated a superior thalamic hemorrhage. On admission to our department 3 mo postinjury, his mental status was good and he was able to walk without assistance, but he had mild ataxia. He complained about severe teeth grinding at night, which began 2 mo postinjury. Botulinum toxin-A was injected into the masseter muscles (20 U in each muscle and temporalis muscles (15 U in each muscle bilaterally. A decrease in bruxism was reported within 3 d. Clinical improvement persisted at assessment 4 mo posttreatment. Botulinum toxin injection can be used as an effective treatment for bruxism associated with brain injury.

  7. [Use of botulinum toxin in strabismus].

    Science.gov (United States)

    Wabbels, B

    2016-07-01

    Botulinum toxin can be a useful tool for treating acute sixth nerve palsy and excessive eye deviations due to unstable Graves' disease, when surgery is not yet possible. The diagnostic injection for estimation of possible postoperative double vision also makes sense. In convergence spasms, periocular botulinum toxin injections can be a therapeutic option. Botulinum toxin is not a first line option in infantile esotropia without binocularity or in adult horizontal strabismus. Side effects include ptosis and vertical deviations. PMID:27369733

  8. Neurophysiological changes induced by the botulinum toxin type A injection in children with cerebral palsy.

    Science.gov (United States)

    Frascarelli, Flaminia; Di Rosa, Giuseppe; Bisozzi, Eleonora; Castelli, Enrico; Santilli, Valter

    2011-01-01

    In the last few years botulinum toxin type A (BTX-A) has been widely used in the management of spasticity in children with cerebral palsy in order to reduce hypertonicity and improve functional outcomes enhancing motor skill development. The botulinum toxin injection seems to interact with intrafusal and extrafusal fibers producing a reduction of hypertone both through synaptic blockade and inhibition of stretch reflex loop and these changes may influence not only the spinal cord but also the central nervous system (CNS). The purpose of our study was to determine the neurophysiological changes induced by the BTX-A through an evaluation of cortical somatosensory Evoked Potential (SEP) and Soleus H wave, that is the index of excitability of stretch reflex loop. Eighteen children with Cerebral Palsy (CP), aged between 5 and 12, were recruited at Children's Hospital "Bambino Gesù" of Rome. All children were evaluated with appropriate clinical scales before and 1 month after the BTX-A injection. Neurophysiological measurements were performed before, and 1 month after botulinum toxin injection through lower limb SEPs, M-wave and Soleus H wave recording. After the injection the results showed a statistically significant improvement both of clinical scales and the neurophysiological variables. These findings suggest that spasticity itself can be considered as a factor affecting the cortical SEPs. And even though it seems that BTX-A does not have any direct central effect on sensory pathways we suppose an indirect mechanism on modulation of afferent fibers Ia due to the modification induced by BTX-A to central loop reflex.

  9. Prostatic Injection of Botulinum A Toxin: An Alternative Treatment for Benign Prostatic Hyperplasia

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    Aliasghar Yarmohamadi

    2009-01-01

    Full Text Available Introduction: We examined the clinical effectiveness of prostate injection of botulinum A toxin in the treatment of BPH. Methods: In this deh1ive study 55 men with BPH who had failed medical treatment and were poor risks for surgery were treated by injection of botulinum A toxin into different parts of the transition zone. Amounts of prostate-specific antigen(PSA prostate symptom scores quality-of-life index prostate volume postvoid residual urine volume and peak urinary flow rates were recorded and compared for all patients before injection and 3 and 6 months after the injection. Results: The mean patient age was 78±2.5 years. The mean symptom score and quality-of-life index significantly improved after 3 months. Maximal urinary flow rate (Qmax showed a significant increase after 3 and 6 months of treatment. Postvoid residual urine volume had a significant decrease after 3 and 6 months (P0.05. Prostate volume decreased from 65±8 ml to 59±6 ml within 1 month and to 49±5 ml within 3 months (P

  10. Botulinum toxin injection for bruxism associated with brain injury: Case report

    OpenAIRE

    Serdar Kesikburun, MD; Rıdvan Alaca, MD; Berke Aras, MD; İlknur Tuğcu, MD; Arif Kenan Tan, MD

    2014-01-01

    Bruxism is involuntary grinding of the teeth and can occur as a complication of brain injury. If untreated, bruxism can lead to severe occlusal trauma. Herein, we present a patient with traumatic brain injury and nocturnal bruxism that was treated with botulinum toxin injection. A 21 yr old male patient with traumatic brain injury from a car accident was admitted to our inpatient rehabilitation unit. He had a history of coma for 2 wk in the intensive care unit. The initial cranial computed to...

  11. Facial Blanching After Cosmetic Botulinum Toxin Injection: Case Series.

    Science.gov (United States)

    Warren, Donald; Woody, Meghan; Vickers, Jennifer

    2016-01-01

    Case 1 A 32-year-old woman was treated for the first time with onabotulinumtoxinA (BoNT), receiving 10 units in her forehead and 20 units in her glabella. She reported no history of skin disease and had a very active lifestyle. She first noticed blanching while doing a group workout and a friend inquired if she had "hives" on her forehead (Figure 1). She continued to note the blanching during workouts 5 months after injection. Each episode lasted 30 minutes to 2 hours. There were no associated symptoms with the blanching other than minor embarrassment. Given her active lifestyle and frequent blanching, she has elected not to receive further injections.

  12. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    Directory of Open Access Journals (Sweden)

    Abiola Jesuloba

    2009-10-01

    Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

  13. Effective Botulinum Toxin Injection Guide for Treatment of Temporal Headache

    Science.gov (United States)

    Choi, You-Jin; Lee, Won-Jae; Lee, Hyung-Jin; Lee, Kang-Woo; Kim, Hee-Jin; Hu, Kyung-Seok

    2016-01-01

    This study involved an extensive analysis of published research on the morphology of the temporalis muscle in order to provide an anatomical guideline on how to distinguish the temporalis muscle and temporalis tendon by observing the surface of the patient’s face. Twenty-one hemifaces of cadavers were used in this study. The temporalis muscles were dissected clearly for morphological analysis between the temporalis muscle and tendon. The posterior border of the temporalis tendon was classified into three types: in Type I the posterior border of the temporalis tendon is located in front of reference line L2 (4.8%, 1/21), in Type II it is located between reference lines L2 and L3 (85.7%, 18/21), and in Type III it is located between reference lines L3 and L4 (9.5%, 2/21). The vertical distances between the horizontal line passing through the jugale (LH) and the temporalis tendon along each of reference lines L0, L1, L2, L3, and L4 were 29.7 ± 6.8 mm, 45.0 ± 8.8 mm, 37.7 ± 11.1 mm, 42.5 ± 7.5 mm, and 32.1 ± 0.4 mm, respectively. BoNT-A should be injected into the temporalis muscle at least 45 mm vertically above the zygomatic arch. This will ensure that the muscle region is targeted and so produce the greatest clinical effect with the minimum concentration of BoNT-A. PMID:27618099

  14. Botulinum toxin injection causes hyperreflexia and increased muscle stiffness of the triceps surae muscle in the rat

    DEFF Research Database (Denmark)

    Pingel, Jessica; Wienecke, Jacob; Lorentzen, Jakob;

    2016-01-01

    and attached to a muscle puller. The resistance of the muscle to stretches of different amplitudes and velocities was systematically investigated. Reflex mediated torque was normalized to the maximal muscle force (Mmax) evoked by supramaximal stimulation of the tibial nerve. Botulinum toxin injection caused...

  15. Botulinum toxin - neuropathic pain: Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    2016-08-12

    When treated with botulinum toxin A, those patients with peripheral neuropathic pain and allodynia (triggering of pain from stimuli which do not normally provoke pain) at baseline, would appear to have a better outcome. PMID:27514345

  16. Ultrasound and Electromyography Guidance for Injection of the Longus Colli With Botulinum Toxin for the Treatment of Cervical Dystonia.

    Science.gov (United States)

    Allison, Stephen K; Odderson, Ib R

    2016-09-01

    Cervical dystonia, also called spasmodic torticollis, is a painful condition in which neck muscles contract involuntarily, and may cause abnormal head position or movements. The primary (or first line of) treatment of cervical dystonia is chemodenervation with injection of botulinum toxin into the affected muscles. We report a case of a young man with idiopathic cervical dystonia who developed anterocollis (forward flexion of the neck) not responsive to prior scalene and sternocleidomastoid muscle injections. To safely access the deeper cervical musculature, ultrasound (US) was used in conjunction with electromyography, to inject the longus colli muscles bilaterally. The patient responded well and had no complications. The longus colli has been reported to be injected using electromyography, fluoroscopy, computed tomography, and, less frequently, US. We propose that US guidance is an excellent technique for botulinum toxin injection, especially for deep cervical muscles such as the longus colli. PMID:26886108

  17. Botulinum Toxin Type a Injection, Followed by Home-Based Functional Training for Upper Limb Hemiparesis after Stroke

    Science.gov (United States)

    Takekawa, Toru; Kakuda, Wataru; Taguchi, Kensuke; Ishikawa, Atsushi; Sase, Yousuke; Abo, Masahiro

    2012-01-01

    Botulinum toxin type A (BoNT-A) has been reported to be an effective treatment for limb spasticity after stroke. However, the reduction in the spasticity after BoNT-A injection alone does not ensure an improvement in the active motor function of the affected limb. The aim of this study was to clarify the clinical effects of a BoNT-A injection,…

  18. Botulinum toxin treatment of hemifacial spasm.

    OpenAIRE

    Elston, J S

    1986-01-01

    Six patients with hemifacial spasm were treated with injections of botulinum toxin A into the orbicularis oculi; the abnormal movements around the eye were relieved for an average of 15 weeks. There were no systemic or significant local side effects, and in view of the risks involved in neurosurgical treatment, a trial of botulinum toxin injections is recommended in the first instance in this condition.

  19. An update on botulinum toxin A injections of trigger points for myofascial pain.

    Science.gov (United States)

    Zhou, Jon Y; Wang, Dajie

    2014-01-01

    Myofascial pain syndrome (MPS) is a common chronic pain condition that is characterized by distinct "trigger points." Despite current treatments with physical therapy, analgesics, anti-depressants and trigger-point injections, myofascial pain remains a challenging chronic pain condition in clinical practice. Botulinum toxin A (BTX-A) can cause prolonged muscle relaxation through inhibition of acetylcholine release. It may offer some advantages over the current treatments for MPS by providing a longer sustained period of pain relief. Despite numerous clinical trials, the efficacy of BTX-A in alleviating MPS is not well-established due to mixed results from recent clinical trials. Active trigger points are associated with referred pain and greatly impact many aspects of activities of daily living, mood, and health status. This review is designed to analyze the clinical trials regarding the efficacy of BTX-A injection of active trigger points as a treatment for MPS. The literature referenced was obtained via a computer search with Google Scholar, Pubmed, Medline and EMbase. Our search terms included "Botulinum toxin," "myofascial pain," "trigger points," "myofascial trigger points," "chronic pain." Additional references were retrieved from the reference list of the reports found via this search. Studies were considered eligible for inclusion if they were double-blinded, randomized, controlled trials evaluating the efficacy of BTX-A injections into trigger points for pain reduction, and if the trigger point selection in the trial included referred pain and/or local twitch response. Open-label studies, case reports, and other non-randomized studies were excluded. Eight trials were found according to the above criteria and are summarized in Table 1. There are well-designed clinical trials to support the efficacy of trigger-point injections with BTX-A for MPS. However, further clinical trials with considerations of minimizing placebo effect, repeated dosing, adequate

  20. Botulinum toxin therapy for hyperhidrosis: reduction of injection site pain by nitrous oxide/oxygen mixtures.

    Science.gov (United States)

    Paracka, Lejla; Kollewe, Katja; Dengler, Reinhard; Dressler, Dirk

    2015-09-01

    Injection site pain (ISP) reduces compliance of botulinum toxin (BT) therapy considerably. We wanted to study whether nitrous oxide/oxygen (NOO, Livopan(®), Linde Gas Therapeutics, Unterschleißheim, Germany) can reduce ISP in patients receiving intracutaneous BT injections for axillary or palmar hyperhidrosis (HH). The study followed an open-label design comparing intraindividually ISP in both axillae and/or both palms when NOO was applied or not during BT injections. BT efficacy was measured by the Hyperhidrosis Disease Severity Scale (HDSS) and by a 4-point Self-Assessment Scale. ISP was documented by a Visual Analogue Scale (VAS) and the Verbal Scale of Pain Intensity (VSPI), adverse effects by a Structuralised Interview (SI). Altogether 13 patients (age 34.1 ± 12.4 years, 9 females, 4 males) were studied. 11 BT treatments were for biaxillary and 3 for bipalmar HH. BT reduced biaxillary HH from HDSS 3.7 ± 0.5 to 1.0 ± 0 and bipalmar HH from 3.6 ± 0.6 to 1.0 ± 0. All patients reported ISP reduction by NOO. In axillary HH, NOO reduced ISP from 55.7 ± 12.7 to 12.8 ± 7.5 on the VAS (p therapy for axillary and palmar HH thus substantially improving compliance of BT therapy.

  1. Long-Term Efficacy and Safety of Botulinum Toxin Injections in Dystonia

    Directory of Open Access Journals (Sweden)

    Juan Ramirez-Castaneda

    2013-02-01

    Full Text Available Local chemodenervation with botulinum toxin (BoNT injections to relax abnormally contracting muscles has been shown to be an effective and well-tolerated treatment in a variety of movement disorders and other neurological and non-neurological disorders. Despite almost 30 years of therapeutic use, there are only few studies of patients treated with BoNT injections over long period of time. These published data clearly support the conclusion that BoNT not only provides safe and effective symptomatic relief of dystonia but also long-term benefit and possibly even favorably modifying the natural history of this disease. The adverse events associated with chronic, periodic exposure to BoNT injections are generally minor and self-limiting. With the chronic use of BoNT and an expanding list of therapeutic indications, there is a need to carefully examine the existing data on the long-term efficacy and safety of BoNT. In this review we will highlight some of the aspects of long-term effects of BoNT, including efficacy, safety, and immunogenicity.

  2. Intragastric injection of botulinum toxin for the treatment of obesity. Where are we?

    Institute of Scientific and Technical Information of China (English)

    Diego Garcia-Compean; Hector Maldonado Garza

    2008-01-01

    Obesity has reached epidemic proportions particularly in western countries. Most non-surgical treatments of this condition are disappointing. Since 2005, several studies evaluating the effect of Botulinum Toxin type A (BT-A) in gastric antrum by means of endoscopy for the treatment of obesity have been published. This treatment modality was based on the observation that gastric injection of BT-A in laparatomized rats induced a significant reduction of food intake and body weight. Nowadays, 6 studies have been published yielding conflicting results. Differences in selection of patients, doses of BT-A, method of administration of the toxin and instruments of evaluation of some parameters among these studies may be the cause of divergent results. We discuss herein some important features of these studies pointing out on differences among them. At the same time, based on the knowledge of physiological characteristics of normal and abnormal gastric function related with feeding, we discuss the probable causes of failure observed in these trials. Finally, we give some guidelines concerning the way that future research in this field may follow, not without calling attention to disadvantages of this treatment.

  3. Effect of treatment with botulinum toxin on spasticity.

    OpenAIRE

    Das, T K; Park, D M

    1989-01-01

    Botulinum toxin, a product of Clostridium botulinum, produces presynaptic neuromuscular block by preventing release of acetylcholine from nerve endings. The toxin was injected directly into the skeletal muscles of six patients with severe spasticity due to stroke-related hemiplegia. It produced both subjective and objective improvement. The toxin injections were well tolerated and no significant side effect was reported.

  4. [Botulinum toxin in disabling dermatological diseases].

    Science.gov (United States)

    Messikh, R; Atallah, L; Aubin, F; Humbert, P

    2009-05-01

    Botulinum toxin could represent nowadays a new treatment modality especially for cutaneous conditions in course of which conventional treatments remain unsuccessful. Besides palmar and plantar hyperhidrosis, botulinum toxin has demonstrated efficacy in different conditions associated with hyperhidrosis, such as dyshidrosis, multiple eccrine hidrocystomas, hidradenitis suppurativa, Frey syndrome, but also in different conditions worsened by hyperhidrosis such as Hailey-Hailey disease, Darier disease, inversed psoriasis, aquagenic palmoplantar keratoderma, pachyonychia congenital. Moreover, different cutaneous conditions associated with sensitive disorders and/or neurological involvements could benefit from botulinum toxin, for example anal fissures, leg ulcers, lichen simplex, notalgia paresthetica, vestibulitis. Endly, a case of cutis laxa was described where the patient was improved by cutaneous injections of botulinum toxin. PMID:19576479

  5. Quantitative evaluation for spasticity of calf muscle after botulinum toxin injection in patients with cerebral palsy: a pilot study

    OpenAIRE

    Lin, Yu-Ching; Lin, I-Ling; Chou, Te-Feng Arthur; Lee, Hsin-Min

    2016-01-01

    Background Cerebral palsy (CP) is the most common pediatric disease to cause motor disability. Two common symptoms in CP are spasticity and contracture. If this occurred in the ankle plantar flexors of children with CP, it will impair their gait and active daily living profoundly. Most children with CP receive botulinum toxin type A (BoNT-A) injection to reduce muscle tone, but a knowledge gap exists in the understanding of changes of neural and non-neural components of spasticity after injec...

  6. INJECTION BOTULINUM IN PARALYTIC STRABISMUS

    Directory of Open Access Journals (Sweden)

    Krishna Kishore

    2015-09-01

    Full Text Available AIM: To assess the effectiveness of botulinum toxin injection to the antagonist muscle in paralytic strabismus. OBJECTIVE: To study the effect of botulinum toxin a injection into the antagonist muscle in cases of paralytic strabismus to alleviate diplopia. MATERIAL AND METHODS: This was a tertiary eye care hospital based prospective interventional study in the department of Orthoptics over a period from October 2011 to October 2013. 36 patients with paralytic strabismus of recent onset within 3 months, with chief complaint of double vision were included. RESULTS: The study data analysis of 36 patients of paralytic strabismus of recent onset (within 3 months with chief complaints of double vision showed a ge wise distribution as 3(8.33% in 0 - 20 years, 16(44.44% in 21 - 40 years, 16(44.44% in 41 - 60 years, 1(2.78% > 60 years. g ender wise 26(72.22% males, 10 (27.28% females, a etiology wise 15(41.67% were diabetic, 4(11.11% were traumatic, 11(30.56% were Id iopathic, 2(5.56% were due to CSOM and 4(11.11% due to Diabetes and Hypertension. All patients were treated with botulinum toxin injection to the antagonist nonoperatic muscle and were followed at an interval of 1 week, 1 month and 3 months. Thorough cli nical examination and Diplopia charting were done before and after treatment. CONCLUSION: Injection botulinum into the antagonist muscle during the first three months after the onset allows the patients to enjoy and appreciate fusion in primary gaze without necessity for head turn, Prevents contracture of antagonist muscle. Thus botulinum toxin is useful in the treatment of acute paretic loss of ocular muscle function when surgical treatment of the ocular muscles is not yet possible but the patient is obviously disturbed by diplopia or forced head posture. The procedure is simple, safe and effective method.

  7. Treatment of Frontal Hyperhidrosis With Botulinum Toxin

    Directory of Open Access Journals (Sweden)

    Ayşe Esra Koku Aksu

    Full Text Available Focal hyperhidrosis is usually localized to the axillae, palms and soles. Less frequently, hyperhidrosis may be confined to the forehead and may have negative impact on patient’s quality of life. A 34-year-old man presented to our clinic with the complaint of frontal hyperhidrosis. He was treated with botulinum toxin A. Thirty points were marked over the forehead and at each injection point, 0.15 ml (3U botulinum toxin A were injected intracutaneously. Hyperhidrosis was significantly reduced and the effect lasted for 12 months. Skindex-29, a quality-of-life measure for skin disease, was administered to the patient at the beginning and at the end of second week of botulinum toxin A injection. There was a significant improvement on the Skindex-29 scale at the end of the treatment. There was no any side effect detected during and after the treatment. Botulinum toxin A treatment is considered to be effective and safe for frontal hyperhidrosis.

  8. Acrylamide inhibits nerve sprouting induced by botulinum toxin type A

    Institute of Scientific and Technical Information of China (English)

    Hong Jiang; Yi Xiang; Xingyue Hu; Huaying Cai

    2014-01-01

    Botulinum toxin type A is a potent muscle relaxant that blocks the transmission and release of acetylcholine at the neuromuscular junction. Intramuscular injection of botulinum toxin type A has served as an effective and safe therapy for strabismus and focal dystonia. However, muscular weakness is temporary and after 3-4 months, muscle strength usually recovers because function-al recovery is mediated by nerve sprouting and reconstruction of the neuromuscular junction. Acrylamide may produce neurotoxic substances that cause retrograde necrotizing neuropathy and inhibit nerve sprouting caused by botulinum toxin type A. This study investigated whether acrylamide inhibits nerve sprouting after intramuscular injection of botulinum toxin type A. A tibial nerve sprouting model was established through local injection of botulinum toxin type A into the right gastrocnemius muscle of Sprague-Dawley rats. Following intramuscular injection, rats were given intraperitoneal injection of 3%acrylamide every 3 days for 21 days. Nerve sprout-ing appeared 2 weeks after intramuscular injection of botulinum toxin type A and single-fiber electromyography revealed abnormal conduction at the neuromuscular junction 1 week after intra-muscular injection of botulinum toxin type A. Following intraperitoneal injection of acrylamide, the peak muscle ifber density decreased. Electromyography jitter value were restored to normal levels 6 weeks after injection. This indicates that the maximal decrease in ifber density and the time at which functional conduction of neuromuscular junction was restored were delayed. Addition-ally, the increase in tibial nerve ifbers was reduced. Acrylamide inhibits nerve sprouting caused by botulinum toxin type A and may be used to prolong the clinical dosage of botulinum toxin type A.

  9. Feasibility of a Day-Camp Model of Modified Constraint-Induced Movement Therapy with and without Botulinum Toxin A Injection for Children with Hemiplegia

    Science.gov (United States)

    Eliasson, Ann-Christin; Shaw, Karin; Ponten, Eva; Boyd, Roslyn; Krumlinde-Sundholm, Lena

    2009-01-01

    The objective of the study was to investigate the feasibility of modified constraint-induced (CI) therapy provided in a 2-week day-camp model with and without intramuscular botulinum toxin type A (BoNT-A) injections for children with congenital cerebral palsy. Sixteen children with congenital hemiplegia, Manual Ability Classification System (MACS)…

  10. A proposal to prevent the "Mephisto sign" side effect of botulinum toxin type A injection in chronic migraine.

    Science.gov (United States)

    Cho, Eunae S; Hwang, Jae Young; Kim, Seong Taek

    2013-11-01

    Botulinum toxin type A (BoNT-A) has been reported as an effective treatment for chronic migraine. When BoNT-A is injected on the frontalis muscle for chronic migraine, an unexpected clinical side effect called the "Mephisto sign" may occur. The aim of this article is to propose a method to eliminate or prevent the Mephisto sign side effect. A 25-year-old female patient visited the hospital and was diagnosed with chronic migraine. A total of 155 U of BoNT-A was injected into 31 sites. 2-weeks later, and the patient developed the Mephisto sign. An additional 2-U dose was administered bilaterally to the lateral-most point of the frontalis muscles, and the eyebrow morphology returned to normal within 2-3 weeks. We propose that the development of the Mephisto sign may be prevented with an additional BoNT-A injection of 2-4 U bilaterally to the lateral most point of the frontalis muscles during the primary injection process.

  11. Botulinum Toxin and Muscle Atrophy: A Wanted or Unwanted Effect.

    Science.gov (United States)

    Durand, Paul D; Couto, Rafael A; Isakov, Raymond; Yoo, Donald B; Azizzadeh, Babak; Guyuron, Bahman; Zins, James E

    2016-04-01

    While the facial rejuvenating effect of botulinum toxin type A is well known and widespread, its use in body and facial contouring is less common. We first describe its use for deliberate muscle volume reduction, and then document instances of unanticipated and undesirable muscle atrophy. Finally, we investigate the potential long-term adverse effects of botulinum toxin-induced muscle atrophy. Although the use of botulinum toxin type A in the cosmetic patient has been extensively studied, there are several questions yet to be addressed. Does prolonged botulinum toxin treatment increase its duration of action? What is the mechanism of muscle atrophy and what is the cause of its reversibility once treatment has stopped? We proceed to examine how prolonged chemodenervation with botulinum toxin can increase its duration of effect and potentially contribute to muscle atrophy. Instances of inadvertent botulinum toxin-induced atrophy are also described. These include the "hourglass deformity" secondary to botulinum toxin type A treatment for migraine headaches, and a patient with atrophy of multiple facial muscles from injections for hemifacial spasm. Numerous reports demonstrate that muscle atrophy after botulinum toxin type A treatment occurs and is both reversible and temporary, with current literature supporting the notion that repeated chemodenervation with botulinum toxin likely responsible for both therapeutic and incidental temporary muscle atrophy. Furthermore, duration of response may be increased with subsequent treatments, thus minimizing frequency of reinjection. Practitioners should be aware of the temporary and reversible effect of botulinum toxin-induced muscle atrophy and be prepared to reassure patients on this matter. PMID:26780946

  12. Application of Botulinum Toxin in Pain Management

    OpenAIRE

    Sim, Woo Seog

    2011-01-01

    Botulinum toxin has been used for the treatment of many clinical disorders by producing temporary skeletal muscle relaxation. In pain management, botulinum toxin has demonstrated an analgesic effect by reducing muscular hyperactivity, but recent studies suggest this neurotoxin could have direct analgesic mechanisms different from its neuromuscular actions. At the moment, botulinum toxin is widely investigated and used in many painful diseases such as myofascial syndrome, headaches, arthritis,...

  13. Botulinum toxin type A for the management of glabellar rhytids

    OpenAIRE

    Tremaine, Anne Marie

    2010-01-01

    Anne Marie Tremaine, Jerry L McCulloughDepartment of Dermatology, University of California, Irvine, CA, USAAbstract: There is an increasing demand for minimally-invasive cosmetic procedures to arrest the aging process. Botulinum toxin type A injections are the most commonly used nonsurgical cosmetic procedures in the United States. There has been research spanning over two decades dedicated to safety, efficacy, dosing, and complications of botulinum toxin type A. There are now two Food and Dr...

  14. Botulinum toxin: yesterday, today, tomorrow

    Directory of Open Access Journals (Sweden)

    A. R. Artemenko

    2013-01-01

    Full Text Available Botulinum toxin (BoNT is a bacterial neurotoxin presented with seven serotypes that inhibit neurotransmitter release from nerve endings. The serotypes of BoNT are antigenically dissimilar, act via different, but interconnected mechanisms, and are not interchangeable. The activity of BoNT is associated with impaired neuroexocytosis occurring in several steps: from the binding of BoNT to its specific receptor on the axon terminal membrane to the proteolytic enzymatic cleavage of SNARE substrate. The effect of BoNT is considered to be restricted to the peripheral nervous system, but when given in particularly high doses, it has been recently shown to affect individual brain structures. In addition, by modulating peripheral afferentation, BoNT may influence the excitability of central neuronal structures at both spinal and cortical levels. Only BoNT serotypes A and B are used in clinical practice and aesthetic medicine. The type A has gained the widest acceptance as a therapeutic agent for more than 100 abnormalities manifesting themselves as muscular hyperactivity, hyperfunction of endocrine gland, and chronic pain. The effect of BoNT preparations shows itself 2-5 days after injection, lasts 3 months or more, and gradually decreases with as a result of pharmacokinetic and intracellular reparative processes. Biotechnology advances and potentialities allow purposefully modification of the protein molecular structure of BoNT, which expands the use and efficiency of performed therapy with neurotoxins. Recombinant technologies provide a combination of major therapeutic properties of each used BoNT serotype and expand indications for recombinant chimeric toxins.

  15. Application of botulinum toxin in pain management.

    Science.gov (United States)

    Sim, Woo Seog

    2011-03-01

    Botulinum toxin has been used for the treatment of many clinical disorders by producing temporary skeletal muscle relaxation. In pain management, botulinum toxin has demonstrated an analgesic effect by reducing muscular hyperactivity, but recent studies suggest this neurotoxin could have direct analgesic mechanisms different from its neuromuscular actions. At the moment, botulinum toxin is widely investigated and used in many painful diseases such as myofascial syndrome, headaches, arthritis, and neuropathic pain. Further studies are needed to understand the exact analgesic mechanisms, efficacy and complications of botulinum toxin in chronic pain disorders.

  16. Botulinum Toxin in Pediatric Neurology

    OpenAIRE

    Moawad, Eman M. I.; Abdallah, Enas Abdallah Ali

    2015-01-01

    Botulinum neurotoxins are natural molecules produced by anaerobic spore-forming bacteria called Clostradium boltulinum. The toxin has a peculiar mechanism of action by preventing the release of acetylcholine from the presynaptic membrane. Consequently, it has been used in the treatment of various neurological conditions related to muscle hyperactivity and/or spasticity. Also, it has an impact on the autonomic nervous system by acting on smooth muscle, leading to its use in the management of p...

  17. Bupivacaine and botulinum toxin to treat comitant strabismus

    Directory of Open Access Journals (Sweden)

    Luisa Moreira Hopker

    2012-04-01

    Full Text Available PURPOSE: To evaluate the change in ocular motility and muscle thickness measured with ultrasonography after intramuscular injection of bupivacaine and botulinum toxin A. METHODS: Eight patients (five female were enrolled to measure ocular motility prior and 1, 7, 30 and 180 days after one injection of 2 ml of 1.5% bupivacaine and 2.5 U of botulinum toxin A in agonist and antagonist muscles, respectively, of eight amblyopic eyes. Muscle thickness was measured prior and on days 1, 7 and 30 after injection using 10-MHz ultrasonography (eyelid technique. RESULTS: Mean change in alignment was 10 prism diopters after 180 days (n=6. An average increase of 1.01 mm in muscle thickness was observed after 30 days of bupivacaine injection and 0.28 mm increase was observed after botulinum toxin A injection, as measured by ultrasonography. Lateral rectus muscles injected with bupivacaine had a mean increase of 1.5 mm in muscle thickness. CONCLUSION: In this study, a change in ocular motility was observed after 180 days of intramuscular injection of bupivacaine and botulinum toxin in horizontal extraocular muscles. Overall, there was an increase of muscle thickness in both botulinum toxinum A and bupivacaine injected muscles after 30 days of injection when measured by ultrasonography. This change was more pronounced on lateral rectus muscles after bupivacaine injection.

  18. Botulinum toxin in the treatment of sialorrhea

    Directory of Open Access Journals (Sweden)

    Svetel Marina

    2009-01-01

    Full Text Available Background/Aim. Botulinum toxin-A (BTX-A is known to block the release of acetylcholine from motor and autonomic nerve terminals and may significantly decrease saliva production when injected intraglandulary. The aim of this study was to evaluate effects of BTX-A injections in the treatment of disabling sialorrhea in various neurological disorders. Methods. This study included 19 consecutive patients with significant sialorrhea associated with various neurological disorders. Out of them 13 patients were with Parkinson's disease, two with pantothenate kinase-associated neurodegeneration, two with multiple system atrophy, one with Wilson's disease, and one patient with postoperative sialorrhea. Botulinum toxin-A (Dysport®, Ipsen Pharma was injected into the parotid glands with (n = 7 patients or without (n = 12 patients ultrasound guidance. All the patients were scored before and after the treatment and in weekly intervals thereafter using the salivation item of the part II (Activities of Daily Living of the Unified Parkinson's Disease Rating Scale (UPDRS. Results. Thirteen patients (68% reported beneficial effect of BTX-A injection, while 6 of them (32% had no response at all. The sialorrhea scores before and after the treatment were 3.1 ± 0.1 (range 2-4 and 1.8 ± 0.1 (range 0- 3, respectively (t = 5.636; p < 0.001. There was no difference in the magnitude of response between the groups with (t = 4.500; p = 0.004 and without (t = 3.674; p = 0.005 ultrasound control of injection sites. Adverse effects were registered in 5 patients (26%. Conclusions. Botulinum toxin-A injections to easily accessible parotid glands, without necessity for ultrasound guidance, are safe and efficaceous treatment for sialorrhea in different neurological disorders.

  19. Botulinum Toxin Therapy

    Science.gov (United States)

    ... resources Meet our partners Español Donate Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases ... toxin therapy public SPOT Skin Cancer™ Diseases and treatments Acne and rosacea Bumps and growths Color problems Contagious skin diseases ...

  20. Comparison of botulinum toxin-A injection in lacrimal gland and conjunctivodacryocystorhinostomy for treatment of epiphora due to proximal lacrimal system obstruction.

    Science.gov (United States)

    Kaynak, P; Karabulut, G O; Ozturker, C; Fazil, K; Arat, Y O; Perente, I; Akar, S; Yilmaz, O F; Demirok, A

    2016-08-01

    PurposeTo investigate and compare the efficacy of botulinum toxin-A injection in the lacrimal gland and conjunctivodacryocystorhinostomy surgery for the treatment of epiphora caused by proximal lacrimal system obstruction.MethodsCharts of the patients with proximal canalicular obstruction who had undergone conjunctivodacryocystorhinostomy with permanent tube insertion (18 patients, group 1) or 4 units of botulinum toxin-A injection in the palpebral lobe of the lacrimal gland (20 patients, group 2) were reviewed retrospectively. The upper lacrimal system obstruction was diagnosed by lacrimal system irrigation. Schirmer-1 test and Munk epiphora grading for evaluation of epiphora were performed before the interventions and on tenth day, first, third, and sixth months after the interventions.ResultsImprovement of epiphora was statistically significant at all visits when compared with values before injection (Pbotulinum toxin-A injection in the lacrimal gland is technically easy, less-invasive, safe, with reversible effects, it can be considered as an alternative treatment in patients with proximal lacrimal system obstruction. PMID:27197871

  1. Overview of Botulinum Toxins for Aesthetic Uses.

    Science.gov (United States)

    Gart, Michael S; Gutowski, Karol A

    2016-07-01

    Botulinum toxin type A (BTA) can be used for facial aesthetics. The 3 currently available BTA types include onabotulinumtoxinA (Botox; Botox Cosmetic, Allergan, Irvine, CA), abobotulinumtoxinA (Dysport; Ipsen, Ltd, Berkshire, UK), and incobotulinumtoxinA (Xeomin; Merz Pharmaceuticals, Frankfurt, Germany). The mechanism of action and clinical uses for treatment of dynamic lines of the forehead, brow, glabella, lateral orbit, nose, and lips are presented, as well as treatment of masseter hypertrophy, platysmal bands, and improvements of the perioral region. Specific BTA injection sites and suggested doses are presented. PMID:27363760

  2. A型肉毒毒素注射治疗腋臭疗效探讨%Effect of Botulinum Toxin type A injection on axillary bromidrosis

    Institute of Scientific and Technical Information of China (English)

    茅付勇

    2015-01-01

    Objective To investigate the clinical value of Botulinum Toxin A on axillary bromidrosis by minimally invasive injection. Methods Using minimally invasive Botulinum Toxin A injection method in the 60 cases of axillary bromidrosis (all of them are bilateral axillary), and then observing the curative effect. Results Of all the 60 patients 58 cases were followed up from March 2011 to June 2014,on average one year and a half,in order to observe the effect and complications and therapeutic effect of them,and the follow- up rate was 96.7% .The curative effect is satisfied. Conclusion Minimally invasive Botulinum Toxin A injection,as a non-operation therapy for axillary bromidrosis,is a method which is simple to operation,easy to master,region without scar,and the curative effect is satisfactory.%目的:探讨微创A型肉毒毒素注射法治疗腋臭的应用价值。方法:采用微创A型肉毒毒素注射法治疗腋臭60例(均为双侧腋窝)观察治疗效果。结果:60例患者中,随访58例,随访率为96.7%。随访时间2011年3月-2014年6月,平均1.5年,疗效满意。结论:微创A型肉毒毒素注射法治疗腋臭操作简单、易于掌握、创区无瘢痕,且疗效满意。

  3. Expression of apoptosis-regulating genes in the rat prostate following botulinum toxin type a injection

    Directory of Open Access Journals (Sweden)

    Gorgal Tiago

    2012-01-01

    Full Text Available Abstract Background Onabotulinumtoxin A (OnabotA injection has been investigated as a novel treatment for benign prostatic enlargement caused by benign prostatic hyperplasia. An OnabotA - induced volume reduction caused by sympathetic fibers impairment has been proposed as a potential mechanism of action. Our aim was to investigate the expression of apoptosis-regulating proteins in the rat prostate following OnabotA intraprostatic injection. Methods Adult Wistar rats were injected in the ventral lobes of the prostate with 10 U of OnabotA or saline. A set of OnabotA-injected animals was further treated with 0.5 mg/kg of phenylephrine (PHE subcutaneously daily. All animals were sacrificed after 1 week and had their prostates harvested. Immunohistochemical staining was performed for Bax, Bcl-xL and caspase-3 proteins and visualized by the avidin-biotin method. The optical density of the glandular cells was also determined, with measurement of differences between average optical densities for each group. Results Saline-treated animals showed intense epithelial staining for Bcl-xL and a faint labelling for both Bax and Caspase-3. OnabotA-treated rats showed a reduced epithelial staining of Bcl-xL and a consistently increased Bax and Caspase-3 staining when compared with saline-treated animals. PHE-treated animals showed a stronger Bcl-xL staining and reduced staining of both Bax and Caspase-3 when compared to the OnabotA group. Mean signal intensity measurements for each immunoreaction confirmed a significant decrease of the signal intensity for Bcl-xL and a significant increase of the signal intensity for Bax and Caspase 3 in OnabotA-injected animals when compared with the control group. In OnabotA+PHE treated animals mean signal intensity for Bcl-xL, Bax and Caspase 3 immunoreactions was identical to that of the control animals. Conclusions These results support the hypothesis that OnabotA activates apoptotic pathways in the rat prostate through a

  4. Muscle selection for treatment of cervical dystonia with botulinum toxin : A systematic review

    NARCIS (Netherlands)

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Kamphuis, D. J.; Tijssen, M. A. J.

    2012-01-01

    Rationale: Cervical dystonia, also called spasmodic torticollis, is the most common form of (primary) dystonia. Intramuscular injections with botulinum toxin are the first line of treatment for cervical dystonia. To optimise the treatment response to botulinum toxin correct muscles should be selecte

  5. Treatment of displaced mandibular condylar fracture with botulinum toxin A.

    Science.gov (United States)

    Akbay, Ercan; Cevik, Cengiz; Damlar, Ibrahim; Altan, Ahmet

    2014-04-01

    The aim of this case report is to discuss the effect on condylar reduction of botulinum toxin A treatment used in a child with displaced fracture at condylar neck of mandible. A 3-years old boy was admitted to our clinic for incomplete fracture of mandibular symphysis and displaced condylar fracture at the left side. An asymmetrical occlusal splint with intermaxillary fixation was used instead of open reduction and internal fixation because of incomplete fracture of symphysis and possible complications of condyle surgery. However, it was observed that condylar angulation persisted despite this procedure. Thus, botulinum toxin A was administered to masseter, temporalis and pterygoideus medialis muscles. At the end of first month, it was seen that mandibular condyle was almost completely recovered and that fusion was achieved. In conclusion, Botulinum A toxin injection aiming the suppression of masticatory muscle strength facilitates the reduction in the conservative management of displaced condyle in pediatric patients. PMID:24156980

  6. An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report.

    Science.gov (United States)

    Kibar, Sibel; Yavuz, Ferdi; Balaban, Birol

    2016-06-01

    Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient's walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport(®)) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy. PMID:27504395

  7. The Effect of Total Cumulative Dose, Number of Treatment Cycles, Interval between Injections, and Length of Treatment on the Frequency of Occurrence of Antibodies to Botulinum Toxin Type A in the Treatment of Muscle Spasticity

    Science.gov (United States)

    Bakheit, Abdel Magid O.; Liptrot, Anthea; Newton, Rachel; Pickett, Andrew M.

    2012-01-01

    A large cumulative dose of botulinum toxin type A (BoNT-A), frequent injections, a short interval between treatment cycles, and a long duration of treatment have all been suggested, but not confirmed, to be associated with a high incidence of neutralizing antibodies to the neurotoxin. The aim of this study was to investigate whether these…

  8. Intraoral administration of botulinum toxin for trigeminal neuropathic pain.

    Science.gov (United States)

    Herrero Babiloni, Alberto; Kapos, Flavia P; Nixdorf, Donald R

    2016-06-01

    This article presents 2 cases of different neuropathic trigeminal pain conditions treated with intraoral botulinum toxin injections. There is a growing body of evidence to support the use of this substance when administered subcutaneously in the treatment of neuropathic pain, such as in extraoral injections for trigeminal neuralgia. However, reports of intraoral submucosal administration are still lacking. In the 2 cases presented here, neuropathic pain was refractory to treatment with an important intraoral peripheral component, so onabotulinum toxin A was introduced as an adjuvant therapy. The technique, doses, and dilution are discussed. The patients reported significant reductions in pain frequency and intensity, with minimal side effects of temporary mucosal dryness and smile droopiness. The analgesic benefits of botulinum toxin may be utilized to address intraoral neuropathic pain. Further studies are needed to confirm safety and effectiveness in larger samples. PMID:27181448

  9. Botulinum Toxin for the Treatment of Tremor and Tics.

    Science.gov (United States)

    Lotia, Mitesh; Jankovic, Joseph

    2016-02-01

    The therapeutic applications of botulinum toxin (BoNT) have grown manifold since its initial approval in 1989 by the U.S. Food and Drug Administration for the treatment of strabismus, blepharospasm, and other facial spasms. Although it is the most potent biologic toxin known to man, long-term studies have established its safety in the treatment of a variety of neurologic and nonneurologic disorders. Despite a paucity of randomized controlled trials, BoNT has been found to be beneficial in treating a variety of tremors and tics when used by clinicians skilled in the administration of the drug for these hyperkinetic movement disorders. Botulinum toxin injections can provide meaningful improvement in patients with localized tremors and tics; in some cases, they may be an alternative to other treatments with more undesirable adverse effects.

  10. Botulinum toxin treatment for lower limb extensor spasticity in chronic hemiparetic patients.

    OpenAIRE

    Hesse, S; Lücke, D; Malezic, M; Bertelt, C; Friedrich, H. (Hergen); Gregoric, M; Mauritz, K H

    1994-01-01

    Twelve chronic hemiparetic outpatients with pronounced lower limb extensor spasticity were injected with 400 units of botulinum toxin A, EMG guided into the soleus, tibialis posterior, and both heads of the gastrocnemius muscles. Botulinum toxin A caused a definite reduction of plantar flexor spasticity, in 10 patients two weeks after the injection, as assessed by the Ashworth scale. Four of the patients were able to achieve active dorsiflexion of their affected ankle. Gait analysis including...

  11. Serum Antibody Response to Clostridium botulinum Toxin in Infant Botulism

    OpenAIRE

    Rubin, Lorry G.; Dezfulian, Manuchehr; Yolken, Robert H.

    1982-01-01

    A serum antibody response has not been previously demonstrated after infection with Clostridium botulinum. We developed an enzyme immunoassay for measuring serum antibody to C. botulinum toxins A, B, and E. This assay system detected a specific immunoglobulin G and immunoglobulin M antibody response to C. botulinum toxin in two patients with infant botulism.

  12. Noncosmetic periocular therapeutic applications of botulinum toxin

    Directory of Open Access Journals (Sweden)

    Kaynak-Hekimhan Pelin

    2010-01-01

    Full Text Available Botulinum toxin blocks acetylcholine release at the neuromuscular junction. The drug which was initially found to be useful in the treatment of strabismus has been extremely effective in the treatment of variety of conditions, both cosmetic and noncosmetic. Some of the noncosmetic uses of botulinum toxin applications include treatment of spastic facial dystonias, temporary treatment of idiopathic or thyroid dysfunction-induced upper eyelid retraction, suppression of undesired hyperlacrimation, induction of temporary ptosis by chemodenervation in facial paralysis, and correction of lower eyelid spastic entropion. Additional periocular uses include control of synchronic eyelid and extraocular muscle movements after aberrant regeneration of cranial nerve palsies. Cosmetic effects of botulinum toxin were discovered accidentally during treatments of facial dystonias. Some of the emerging nonperiocular application for the drug includes treatment of hyperhidrosis, migraine, tension-type headaches, and paralytic spasticity. Some of the undesired side effects of periocular applications of botulinum toxin inlcude ecchymosis, rash, hematoma, headache, flu-like symptoms, nausea, dizziness, loss of facial expression, lower eyelid laxity, dermatochalasis, ectropion, epiphora, eyebrow and eyelid ptosis, lagophthalmos, keratitis sicca, and diplopia.

  13. Ultrasound-Guided Injection of Botulinum Toxin Type A for Piriformis Muscle Syndrome: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andrea Santamato

    2015-08-01

    Full Text Available Piriformis muscle syndrome (PMS is caused by prolonged or excessive contraction of the piriformis muscle associated with pain in the buttocks, hips, and lower limbs because of the close proximity to the sciatic nerve. Botulinum toxin type A (BoNT-A reduces muscle hypertonia as well as muscle contracture and pain inhibiting substance P release and other inflammatory factors. BoNT-A injection technique is important considering the difficult access of the needle for deep location, the small size of the muscle, and the proximity to neurovascular structures. Ultrasound guidance is easy to use and painless and several studies describe its use during BoNT-A administration in PMS. In the present review article, we briefly updated current knowledge regarding the BoNT therapy of PMS, describing also a case report in which this syndrome was treated with an ultrasound-guided injection of incobotulinumtoxin A. Pain reduction with an increase of hip articular range of motion in this patient with PMS confirmed the effectiveness of BoNT-A injection for the management of this syndrome.

  14. The Efficacy of Botulinum Toxin Type a Injection in the Hamstring and Calf Muscles With and Without Serial Foot Casting in Gait Improvement in Children With Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Shamsodini A

    2011-11-01

    Full Text Available Background: The goal of this study was to compare the efficacy of botulinum toxin type A (BTX-A injection in the hamstring and calf muscles with and without ankle serial casting in the improvement of gait in children with cerebral palsy (CP.Methods : This double-blind prospective clinical trial was performed on 25, 2 to 8-year-old children with hemiplegic or diplegic CP in Tehran, Iran in 2010. The participants were chosen by simple randomized sampling and were matched for age, gross motor function classification system (GMFCS and type of CP and were randomly divided into two groups: children in the first group (13 only received BTX-A injection, but the second group (12 received BTX-A and serial foot casting starting one week after the injection.Results : Comparison of the gross motor function, right and left knee spasticities and passive ROM of both knees between the two groups before and 1, 3, 6 and 12 months after the injections were not statistically significant (P>0.1. Furthermore, comparison of the right and left ankle spasticities and passive ROM before the injections and in1 and 3-month follow-ups did not show a statistically significant difference (P>0.1, but the differences were significant in 6 and 12-month follow-ups (P<0.05.Conclusion: BTX-A injection with serial foot casting vs. BTX-A alone was more effective in decreasing spasticity and improving passive ROM in the ankle of children with CP, but such injections in the hamstrings were not useful in these regards.

  15. Botulinum toxin A in the treatment of anal fissure

    Directory of Open Access Journals (Sweden)

    Stanković Nebojša

    2004-01-01

    Full Text Available Background. This paper presents our first experience in the treatment of primary anal fissure by injection of botulinum A toxin into the internal sphincter. Methods. The study group of the retrospective study included 12 outpatients (8 females and 4 males, mean age 42 (range 18-60. During the period 2000-2003, after unsuccessful conservative treatment, patients were treated with the injections of botulinum A toxin, 100 units on both sides of the anal fissure laterally into the internal anal sphincter (50 units on either side. The patients were clinically evaluated 3, 7, and 30 days, and 3 and 6 months after the treatment. Results. Three fissures had healed after a month, and seven after 3 months. Two remained unhealed, but asymptomatic. There was no incontinence of flatus or faeces after 3 months of the treatment. After temporary healing, two fissures relapsed after 6 months, and these patients had the adequate tonus of the anal sphincter muscles. Except for the temporary incontinence, there were neither other side-efects, nor serious complications. Conclusion. Injection of botulinum A toxin achieved good results in the treatment of anal fissure. The appropriate use makes this method safe as an alternative to surgical treatment of anal fissure.

  16. A Beautician's Dystonia: Long-Lasting Effect of Botulinum Toxin

    Science.gov (United States)

    Di Martino, Siria; Dalise, Stefania; Lamola, Giuseppe; Venturi, Martina; Rossi, Bruno; Chisari, Carmelo

    2014-01-01

    Treatment options for dystonia are not curative but symptomatic; the treatment of choice for focal dystonias is repeated botulinum toxin injections. Here, we present the case of a 46-year-old beautician with focal dystonia in her left hand that affected her ability to work. Pharmacological treatment with clonazepam and gabapentin failed to resolve her symptoms and was discontinued due to side effects (sleepiness, gastrointestinal disorders). Intramuscular injection of botulinum toxin (incobotulinumtoxinA, Xeomin) into the extensor digitorum communis (35 U), flexor carpi radialis (35 U), and flexor digitorum superficialis (30 U) muscles resulted in complete resolution of symptoms at clinical assessments at 1, 3, 6, and 10 months after the injections, confirmed by the results of surface electromyography 10 months after treatment. The patient was able to work again 1 month after treatment. No reinjection has been necessary at the last evaluation (12 months after treatment). In conclusion, botulinum toxin is an effective treatment for focal dystonia that can have long-lasting effects and can improve patients' ability to work and quality of life. PMID:25143844

  17. A型肉毒素治疗面部皱纹的临床疗效观察%The Observation effect of Botulinum Toxin type A injections in treatment of facial wrinkle

    Institute of Scientific and Technical Information of China (English)

    袁亮飞; 刘静; 刘安久; 曹进军

    2012-01-01

      Objective:To observe the effect of Botulinum Toxin type A injections in treatment of facial wrinkle. Methods:A total of 91 patients were included. Botulinum Toxin type A inject their facial wrinkle,the different local with different doses,fixed uniform inject. Results:91 patients were satisfied with the treatment. Conclusions:Botulinum Toxin type A injections therapy is a effective methods for treatment facial wrinkle. The therapeutic effect is obvious ,rapid and the side effects minimal.%  目的观察A型肉毒素(BTXA)治疗面部皱纹的疗效。方法对91例面部皱纹患者利用A型肉毒素根据部位不同,分别采用不同剂量,定点均匀注射。结果91例患者经治疗后均获得满意疗效。结论 A型肉毒素在面部除皱中有确切的疗效,且痛苦小、见效快、副作用少。

  18. Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper

    OpenAIRE

    Imms Christine; Hoare Brian J; Rawicki Hyam; Carey Leeanne

    2010-01-01

    Abstract Background Use of Botulinum toxin-A (BoNT-A) for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. There is now high-level evidence that upper limb BoNT-A injection, in combination with occupational therapy, improves outcomes in children with cerebral palsy at both the body function/structure and activity level domains of the International Classification of Functioning, Disability an...

  19. Botulinum toxin A injection for facial analysis the clinical efficacy and safety of facial wrinkles%A型肉毒毒素面部除皱的临床观察

    Institute of Scientific and Technical Information of China (English)

    王忠志; 刘茜

    2014-01-01

    目的:了解A型肉毒毒素面部注射进行面部除皱的临床疗效及安全性。方法回顾性分析我院2012年3月至2014年3月收治的64例行面部除皱的患者的临床资料,均应用A型肉毒毒素进行面部注射治疗,分析其临床疗效与安全性。结果64例患者经由A型肉毒毒素面部注射治疗后,所取得的效果较为理想,仅1例鼻部除皱术疗效欠佳。结论 A型肉毒毒素面部注射进行面部除皱临床疗效确切,不良反应少,值得临床大力推广与应用。%Objective: To investigate the botulinum toxin type A injection for facial clinical efficacy and safety of facial wrinkles. Methods: retrospective analysis of clinical data in our hospital from 2012 March to 2014 March treated 64 cases of facial wrinkles patients, both the application of botulinum toxin type A injection in the treatment of facial, analyze its clinical efficacy and safety. Results: 64 patients with botulinum toxin A injection for facial treatment, the effect is more ideal, only 1 cases of nasal rhytidectomy curative effect. Conclusion: botulinum toxin A injection for facial facial rhytidectomy clinical curative effect, less adverse reaction, it is worthy of clinical popularization and application.

  20. Occlusal force characteristics of masseteric muscles after intramuscular injection of botulinum toxin A(BTX - A)for treatment of temporomandibular disorder.

    Science.gov (United States)

    Zhang, Long-Dan; Liu, Qi; Zou, De-Rong; Yu, Lv-Feng

    2016-09-01

    Our aim was to evaluate the occlusal force and therapeutic efficacy of the masseteric muscles after intramuscular injection of botulinum toxin A (BTX-A) for the treatment of patients with concurrent temporomandibular disorders (TMD) and bruxism. Thirty patients with TMD associated with bruxism were randomised into three groups (n=10 in each group), and treated by bilateral intramuscular injection of BTX-A into the masseter, placebo, or control. We used an occlusal force analysis system to collect several measures of occlusal force such as duration of biting and closing, the maximum occlusal force, and the distribution of occlusal force. The occlusal force in the intercuspid position was reduced in all three groups. There was a significant difference between the BTX-A and placebo groups (F(df=1)=8.08, p=0.01) but not between the control group and the other two(F(df=1)=4.34, p=0.047). The duration of occlusion was significantly increased in the BTX-A group after 3 months' treatment (t=4.07, p=0.003). The asymmetrical distribution of occlusal force was reduced in all three groups, but not significantly so (Levene's test F(df=2)=0.25, p=0.78,ANOVA F(df=2)=0.50, p=0.61). Treatment of TMD with BTX-A is effective in reducing the occlusal force, but psychological intervention plays an important part in treatment. PMID:27138229

  1. [Treatment of blepharospasm with botulinum toxin].

    Science.gov (United States)

    Pikielny, R T; Micheli, F E; Fernández Pardal, M M; Casas Parera, I; Giannaula, R J; Gatto, M

    1990-01-01

    Blepharospasm is a relatively frequent cranial dystonia which may be seen either alone or related to orofacial-mandibular dystonia (Meige's syndrome). In its maximum degree it can cause functional blindness.Twelve patients with blepharospasm (4 essential and 8 Meige's syndrome) who had been previously treated unsuccessfully with drugs (trihexyphenidyl, biperiden, carbamazepine, lithium, baclofen, lisuride, imipramine, clonazepam and butyrophenones) were treated for 12 months with periocular injections of botulinum toxin (BOTOX). A "low" dose of 12,5 U per eye was employed. With this dose, eleven out of twelve patients experienced significant improvement which lasted from five to fifteen weeks. The only nonresponder obtained complete relief upon duplicating the dose. The only side effect was uni or bilateral ptosis in six patients which improved completely in seven to twenty one days. One patient developed a peripheral facial palsy with complete remission in nineteen days. No systemic side effects were noted. There was only one desertion from this study due to depression enhanced by prolonged (21 days) ptosis. All patients (including the deserter) agreed that treatment with BOTOX provided more relief than any other previous therapeutic method. Our results confirm those obtained by others but a more prolonged study is needed to better evaluate long term effects. PMID:2101846

  2. Bruxism secondary to brain injury treated with botulinum toxin-A: a case report.

    OpenAIRE

    Swinson Brian; Upile Tahwinder; Jerjes Waseem; El Maaytah Mohammed; Hopper Colin; Ayliffe Peter

    2006-01-01

    Abstract We report a successful treatment of bruxism in a patient with anoxic brain injury using botulinum toxin-A (BTX-A). On examination the mouth opening was 0 mm, no feeding was possible through the mouth. Botulinum toxin was injected into the masseter and temporalis; great improvement in trismus and bruxism was noted after 3 weeks. One further treatment improved the mouth opening on the following week and the patient was discharged from our care to be reviewed when required.

  3. Cervical dystonia : Improved treatment response to botulinum toxin after referral to a tertiary centre and the use of polymyography

    NARCIS (Netherlands)

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Standaar, T. S. M.; Postma, Marten; Tijssen, M. A. J.

    2013-01-01

    Rationale: Cervical dystonia is the most common form of (primary) dystonia. The first line of treatment for cervical dystonia is intramuscular injections with botulinum toxin. To optimise the response to botulinum toxin proper muscles selection is required. Pre-treatment polymyographic EMG in additi

  4. Botulinum Toxin in the Treatment of Facial Paralysis.

    Science.gov (United States)

    Mehdizadeh, Omid B; Diels, Jacqueline; White, William Matthew

    2016-02-01

    This article reviews the current literature supporting the use of botulinum toxin in producing symmetric facial features and reducing unwanted, involuntary movements. Methods, protocols, and adverse events are discussed. Additionally, the authors suggest that using botulinum toxin A therapy in postparalytic facial synkinesis can provide long-term results when used in conjunction with other treatment modalities.

  5. Subtenon injection of botulinum toxin A for treatment of paralytic strabismus without electromyograph guidance%非肌电图引导注射A型肉毒毒素治疗麻痹性斜视的临床研究

    Institute of Scientific and Technical Information of China (English)

    曾莉; 郝更生; 卢薇; 李玉茹; 税丹

    2011-01-01

    目的:评价非肌电图引导Tenon氏囊下注射A型肉毒毒素治疗麻痹性斜视的效果.方法:对后天性麻痹性斜视36例(36只眼)采用直视Tenon氏囊下注射A型肉毒毒素,观察近期及远期疗效.结果:注射肌肉:内直肌30只眼,外直肌6只眼.注射剂量2.5~5.0u(平均2.35u),注射后5~14天(平均9.36天)可达最大肌肉麻痹作用,斜视矫正度平均39.20△.近期治愈率44.4%,显效率72.2%.3个月后重复注射者17例,总治愈率58.3%.结论:非肌电图仪引导的Tenon氏囊下注射与肌电图引导的肌肉内注射疗效相似,对中低度麻痹性斜视有良好的治疗效果,对大角度斜视可以减少斜度.%Objective To evaluate the efficacy of subtenon injection of botulinum toxin A without elec-tromyography (EMG) guidance for treatment of paralytic strabismus. Methods 36 cases (36 eyes) with acquired paralytic strabismus were treated with subtenon injection of botulinum toxin A . The deviation angles before and after injection were recorded, the short-term and long- term therapeutic effect were observed. Results 30 eyes' rec-tus medialis and 6 eyes' rectus lateralis were treated. The injection dose was 2.5~5.0u (averge 2.35u), The maximum therapeutic paralytic effect occurred in 5 ~ 14 days following the injection, The mean correction of strabismus was 39.20 prism diopters. The short-term recovery rate was 44.4%, the clinical effective rate was 72.2%, 17 cases received repeated, injections alter 3 months, the total recovery rate was 58.3%. Conclusions The result of subtenon injection of botulinum toxin without electromyography (EMC) guidance was comparable to that obtained using EMG-guided intramuscular injection of botulinum toxin. It is effective to low and moderate paralytic strabismus, and can reduce deviation to large angel strabismus.

  6. Botulinum toxin and its clinical aspects: An overview

    Directory of Open Access Journals (Sweden)

    Shatavisa Mukherjee

    2015-01-01

    Full Text Available Botulinum toxin (BTX, a potent neurotoxin which is produced by the bacterium Clostridium botulinum, consists of eight distinct neurotoxin serotypes referred to as (BTX type-A [BTX-A], B, C, D, E, F, G, H all of which inhibit acetylcholine release at the neuromuscular junction. BTX-A, by blocking acetylcholine release at neuromuscular junctions, accounts for its therapeutic action to relieve dystonia, spasticity, and related disorders. A wide variety of medical conditions such as bruxism, hyperhidrosis, achalasia, focal dystonia, upper motor neuron syndrome, blepharospasm, and chronic migraine are now treated with BTX. The cosmetological applications include correction of lines, creases, and wrinkling all over the face, chin, neck, and chest. Side effects are generally rare and minimal. Injections with BTX-A are well-tolerated. Discovery of further newer indications of this neurotoxin can enlighten the path of research in the field of neuroscience.

  7. Botulinum toxin for treatment of glandular hypersecretory disorders.

    LENUS (Irish Health Repository)

    Laing, T A

    2012-02-03

    SUMMARY: The use of botulinum toxin to treat disorders of the salivary glands is increasing in popularity in recent years. Recent reports of the use of botulinum toxin in glandular hypersecretion suggest overall favourable results with minimal side-effects. However, few randomised clinical trials means that data are limited with respect to candidate suitability, treatment dosages, frequency and duration of treatment. We report a selection of such cases from our own department managed with botulinum toxin and review the current data on use of the toxin to treat salivary gland disorders such as Frey\\'s syndrome, excessive salivation (sialorrhoea), focal and general hyperhidrosis, excessive lacrimation and chronic rhinitis.

  8. Treatment of scar contracture with intralesional botulinum toxin type A injection%A型肉毒毒素治疗挛缩性瘢痕

    Institute of Scientific and Technical Information of China (English)

    颜彤彤; 陈敏亮; 马奎; 梁黎明; 刘畅; 赖林英; 付小兵

    2013-01-01

    Objective To evaluate the validity of botulinum toxin type A (BTXA) injections for the treatment of scar contracture.Methods 26 patients with scar contracture were randomly assigned into BTXA group and triamcinolone acetonide (TAC) group.Pinpoint tattooing was performed on each side of each scar in the plane of its longest axis.A template was used to ensure consistent length.These two tattoo points were measured to assess scar contraction at baseline,at every month for a total of 6 months.Histological analysis was conducted to study the physiological environment and immunohistochemistry to detect the expression of α-SMA and myosin-Ⅱ at different groups.Results Scar contraction was more relaxed in BTXA group than that in TAC group after 1 month (P<0.05),especially in the 6th month (the D value in BTXA group and TAC group was (1.23±0.42) cm,and (0.56±0.33) cm respectively).For immunohistochemistry,the expression of α-SMA and myosin-Ⅱ also decreased in BTXA group (P<0.05).Conclusions The treatment of scar contracture by suitable BTXA injections is safe and effective.%目的 探索A型肉毒毒素(botulinum toxin type A,BTXA)治疗挛缩性瘢痕的疗效.方法 选取26例挛缩性瘢痕患者,随机分为A型肉毒毒素组(BTXA组)和曲安奈德组(TAC组,对照组),注射药物治疗前测量各组患者瘢痕长轴长度,并于注射后再次测量其长度,1次/月,共6次,通过比较治疗前后差值评价药物疗效.切取各组瘢痕组织行免疫组织化学检测,观察α平滑肌肌动蛋白(α-SMA)及肌球蛋白-Ⅱ的表达情况.结果 药物作用1个月后,BTXA组较TAC组瘢痕挛缩程度明显减轻(P<0.05),尤以6个月时差异最明显,BTXA组和TAC组瘢痕长轴长度差值分别为(1.23±0.42) cm和(0.56±0.33) cm.免疫组织化学结果显示,BTXA组瘢痕内α-SMA及肌球蛋白-Ⅱ表达较TAC组明显减少(P<0.05).结论 A型肉毒毒素治疗挛缩性瘢痕操作简单、效果明显,值得推广应用.

  9. Intravesical Botulinum Toxin A Injections for Bladder Pain Syndrome/Interstitial Cystitis: A Systematic Review and Meta-Analysis of Controlled Studies.

    Science.gov (United States)

    Wang, Junpeng; Wang, Qiang; Wu, Qinghui; Chen, Yang; Wu, Peng

    2016-01-01

    BACKGROUND The role of intravesical botulinum toxin A (BTX-A) injections in bladder pain syndrome/interstitial cystitis (BPS/IC) has not been clearly defined. The aim of this study was to evaluate high-level evidence regarding the efficacy and safety of BTX-A injections for BPS/IC. MATERIAL AND METHODS We conducted a comprehensive search of PubMed, Embase, and Web of Science, and conducted a systematic review and meta-analysis of all available randomized controlled trials (RCTs) and controlled studies assessing BTX-A injections for BPS/IC. RESULTS Seven RCTs and 1 retrospective study were identified based on the selection criteria. Pooled analyses showed that although BTX-A was associated with a slightly larger volume of post-void residual urine (PVR) (weighted mean difference [WMD] 10.94 mL; 95% confidence intervals [CI] 3.32 to 18.56; p=0.005), patients in this group might benefit from greater reduction in pelvic pain (WMD -1.73; 95% CI -3.16 to -0.29; p=0.02), Interstitial Cystitis Problem Index (ICPI) scores (WMD -1.25; 95% CI -2.20 to -0.30; p=0.01), and Interstitial Cystitis Symptom Index (ICSI) scores (WMD -1.16; 95% CI -2.22 to -0.11; p=0.03), and significant improvement in daytime frequency of urination (WMD -2.36; 95% CI -4.23 to -0.49; p=0.01) and maximum cystometric capacity (MCC) (WMD 50.49 mL; 95% CI 25.27 to 75.71; p<0.00001). Nocturia, maximal urinary flow rate, dysuria, and urinary tract infection did not differ significantly between the 2 groups. CONCLUSIONS Intravesical BTX-A injections might offer significant improvement in bladder pain symptoms, daytime urination frequency, and MCC for patients with refractory BPS/IC, with a slightly larger PVR. Further well-designed, large-scale RCTs are required to confirm the findings of this analysis. PMID:27624897

  10. High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

    Science.gov (United States)

    Manske, Sarah L; Good, Craig A; Zernicke, Ronald F; Boyd, Steven K

    2012-01-01

    High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB) would maintain bone in a muscle disuse model with botulinum toxin type A (BTX). Female 16-18 wk old BALB/c mice (N = 36) were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass) into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA) and tibial bone properties (epiphysis, metaphysis and diaphysis) were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX. PMID:22590551

  11. High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

    Directory of Open Access Journals (Sweden)

    Sarah L Manske

    Full Text Available High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB would maintain bone in a muscle disuse model with botulinum toxin type A (BTX. Female 16-18 wk old BALB/c mice (N = 36 were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA and tibial bone properties (epiphysis, metaphysis and diaphysis were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX.

  12. A型肉毒毒素联合透明质酸注射治疗面部老化临床疗效观察%Botulinum toxin A joint hyaluronic acid injection Facial aging treatment clinical curative effect observation

    Institute of Scientific and Technical Information of China (English)

    王芳芳; 张东晓; 熊玮; 王艳; 徐丽红

    2015-01-01

    Objective:To observe the clinical effect and safety of botulinum toxin type A and Hyaluronic Acid injection appliedin the treatmernt of facial skin aging.Methods:45 patients of different skin aging problem, according to botulinum toxin type A,and hyaluronic acid injection therapy. All patients were followed up and observed treatment effect and prognosis.Results:45 patients with skin aging problem has been improved to varying degrees of, treatment effective rate was 83.11%. Postoperative adverse reactions and are temporary, recovering well.Conclusion:Combined botulinum toxin A and hyaluronic acid injection treatment of facial skin aging good curative effect, patient satisfaction is high, safe and effective.%目的:探讨A型肉毒毒素、透明质酸注射联合治疗面部皮肤老化疗效及安全性。方法:对45例患者面部老化问题,采用A型肉毒毒素联合透明质酸注射治疗,观察治疗效果。结果:患者面部老化问题得到不同程度的改善,治疗有效率83.11%,术后不良反应轻且都是暂时性,恢复良好。结论:A型肉毒毒素联合透明质酸注射治疗面部皮肤老化疗效好,患者满意度高,安全有效。

  13. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley Megan; Donaghey Samantha; Edwards Priya; Copeland Lisa; Kentish Megan; McLennan Kim; Lindsley Jayne; Gascoigne-Pees Laura; Sakzewski Leanne; Boyd Roslyn N

    2012-01-01

    Abstract Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alo...

  14. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    OpenAIRE

    Thorley, Megan; Donaghey, Samantha; Edwards, Priya; Copeland, Lisa; Kentish, Megan; McLennan, Kim; Lindsley, Jayne; Gascoigne-Pees, Laura; Sakzewski, Leanne; Boyd, Roslyn N.

    2012-01-01

    Background Children with cerebral palsy (CP) whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A) combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V), compared with standard therapy alone (cycle...

  15. A型肉毒毒素用于治疗痉挛型脑性瘫痪的临床研究%A clinical study on botulinum toxin A injection for spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    王志娇; 肖农

    2011-01-01

    Objective: To evaluate the clinical value of botulinum toxin A injection for spastic cerebral palsy(CP) children.Method: Two hundred patients children with spastic cerebral palsy were divided into 2 groups, a group treated with botulinum toxin A injection (injection group) treated and a group treated with rehabilitation treatment(control group). For injection group, botulinum toxin A was accurately injected into the spasticity muscle of CP children,and 24h after injection children received continuous rehabilitation training for 12 weeks. For control group, CP children received rehabilitation training only. Before treatment and 1 week, 2 weeks, 4 weeks, 8 weeks and 12weeks after treatment, muscle spasticity and movement function were evaluated by modified Ashworth scale, gross motor function measure and physician rating scale.Result: The improvement of muscle spasticity and scores of movement function in injection group were better than before treatment. The therapeutic effects in injection group were better than that in control group.Conclusion: Botulinum toxin A injection could reduce CP children's spasticity quickly and effectively. Compared with simple rehabilitation training, botulinum toxin A injection in combination with rehabilitation training could improve movement function and shorten the period of treatment significantly.%目的:探讨A型肉毒毒素注射治疗痉挛型脑性瘫痪儿童肌肉痉挛的疗效.方法:选择痉挛型脑性瘫痪儿童200例,A型肉毒毒素注射组(注射组)和单纯康复治疗组(对照组)各100例.其中注射组将A型肉毒毒素准确注射到患儿痉挛肌群,注射后次日开始进行康复训练(共12周).所有病例在治疗前及治疗后1周、2周、4周、8周、12周分别采用改良Ashworth量表、粗大运动功能量表及医师等级评价量表进行相关评价.结果:注射组在注射后各观察时点肌肉痉挛改善程度和运动功能评分均优于注射前(P<0.05),注射组治疗

  16. Botulinum Toxin Physiology in Focal Hand and Cranial Dystonia

    Directory of Open Access Journals (Sweden)

    Barbara Illowsky Karp

    2012-11-01

    Full Text Available The safety and efficacy of botulinum toxin for the treatment of focal hand and cranial dystonias are well-established. Studies of these adult-onset focal dystonias reveal both shared features, such as the dystonic phenotype of muscle hyperactivity and overflow muscle contraction and divergent features, such as task specificity in focal hand dystonia which is not a common feature of cranial dystonia. The physiologic effects of botulinum toxin in these 2 disorders also show both similarities and differences. This paper compares and contrasts the physiology of focal hand and cranial dystonias and of botulinum toxin in the management of these disorders.

  17. Cosmetic Effect of Botulinum Toxin In Focal Hyperhydrosis

    Directory of Open Access Journals (Sweden)

    Jain S

    2005-01-01

    Full Text Available Hyperhydrosis of axillae, palm and sole is not a very uncommon problem. It leads to great embarrassment and considerable emotional stress to the individuals. Botulinum toxins prevent the release of acetylcholine at nerve terminals, therefore, reduces sweat secretion. Six patients of axillary and 4 patients of palmer and planter hyperhydrosis were treated with botulinum toxin. All patients experienced relatively satisfactory reduction of hyperhydrosis for period ranging between 4-7 months. No adverse effects were observed. Botulinum toxin therefore can be considered as an effective treatment in focal hyperhydrosis.

  18. Use of Botulinum toxin in 55 children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Mohammadi M

    2000-10-01

    Full Text Available Botulinum toxin A (BTA inhibits presynaptic release of acetylcholine at the neuromuscular junction and has reportedly been successful in the treatment of spastic disorders.To evaluate the effect of botulinum toxin on cerebral palsied children with spastic or mixed type of the disease, especially those patiens having spasticity as a cardinal symptom without joint contracture, we designed the following study. Ninety-one cases (55 of referred patients to pediatic Neurology outpatient clinics of children’s Medical Center were given BTA injections in affected muscles of the lower limb. They were reevaluating 3 to 5 weeks and 3 months later for type of walking and range of affected joints’ movement. The study showed a clinically significant gait improvement in 71.2% of patients (P<0.0005 and also an overall increased range of motion in affected limbs after BTA injection (P<0.04. Side effects occurred only in two cases as transient generalized weakness, gent recurvatum and ptosis. Drug effectiveness was time-limited, lasting abot 3 months in all patients ( a golden time for rehabilitation therapists to improve the patients’ condition. Overall, BTA has improved both the type of walking as well as the range of joints motion in our patients. So its’ administration is suggested in cerebral palsied children if the spasticity is a major and disabling sign

  19. Reconstituting botulinum toxin drugs: shaking, stirring or what?

    Science.gov (United States)

    Dressler, Dirk; Bigalke, Hans

    2016-05-01

    Most botulinum toxin (BT) drugs are stored as powders which need to be reconstituted with normal saline before clinical use. As botulinum neurotoxin (BNT), the therapeutically active ingredient, is a large double-stranded protein the process of reconstitution should be performed with special attention to mechanical stress applied. We wanted to test the mechanical stability of BNT during the reconstitution process. For this, 100 MU onabotulinumtoxinA (Botox(®), Irvine, CA, USA) was reconstituted with 2.0 ml of NaCl/H2O. Gentle reconstitution (GR) was performed with a 5 ml syringe, a 0.90 × 70 mm injection needle, one cycle of injection-aspiration-injection and two gentle shakes of the vial. Aggressive reconstitution (AR) was performed with a 5 ml syringe, a 0.40 × 40 mm injection needle, ten injection-aspiration-injection cycles and 30 s of continuous shaking of the vial. AR increased the time to paralysis in the mouse hemidiaphragm assay (HDA) from 72.0 ± 4.6 to 106.0 ± 16.0 min (*p = 0.002, two-tailed t test after Kolmogorov-Smirnova test with Lilliefors correction for normal distribution). Construction of a calibration curve revealed that the increase in the time to paralysis was correlated with a loss of potency of from 100 to 58 MU (-42 %). BT users should use large diameter injection needles for reconstitution, apply two or three injection-aspiration-injection cycles and, maybe, shake the vials a few times to rinse the entire glass wall. Aggressive reconstitution with small diameter needles, prolonged injection-aspiration-injection and violent shaking should be avoided.

  20. Botulinum Toxin Physiology in Focal Hand and Cranial Dystonia

    OpenAIRE

    Barbara Illowsky Karp

    2012-01-01

    The safety and efficacy of botulinum toxin for the treatment of focal hand and cranial dystonias are well-established. Studies of these adult-onset focal dystonias reveal both shared features, such as the dystonic phenotype of muscle hyperactivity and overflow muscle contraction and divergent features, such as task specificity in focal hand dystonia which is not a common feature of cranial dystonia. The physiologic effects of botulinum toxin in these 2 disorders also show both similarities an...

  1. Botulinum Toxin to Treat Neurogenic Bladder.

    Science.gov (United States)

    Smith, Christopher P; Chancellor, Michael B

    2016-02-01

    Alteration in neural control from suprapontine areas to the nerves innervating the bladder can lead to bladder dysfunction and the development of a neurogenic bladder (NGB). Patients with NGB often suffer from urinary incontinence, which can lead to adverse events such as urinary tract infections and decubiti, in addition to creating a large care burden for family members or healthcare providers and significantly impairing patient quality of life. The common failure of anticholinergic medications has spurned the development of second-line treatments, including the use of botulinum toxin. OnabotulinumtoxinA (onaBoNT-A; BOTOX, Allergan, Inc.) was approved by the U.S. Food and Drug Administration (FDA) in 2011 to treat neurogenic detrusor overactivity in patients with urinary incontinence resulting from a NGB. In this review the authors summarize pertinent results from key trials leading to FDA approval of onaBoNT-A as well as more recent long-term data.

  2. Botulinum toxin drugs: brief history and outlook.

    Science.gov (United States)

    Dressler, D

    2016-03-01

    The global botulinum toxin (BT) market is currently undergoing rapid changes: this may be the time to review the history and the future of BT drug development. Since the early 1990s Botox(®) and Dysport(®) dominated the international BT market. Later, Myobloc(®)/NeuroBloc(®), a liquid BT type B drug, came out, but failed. Xeomin(®) is the latest major BT drug. It features removal of complexing proteins and improved neurotoxin purity. Several new BT drugs are coming out of Korea, China and Russia. Scientific challenges for BT drug development include modification of BT's duration of action, its transdermal transport and the design of BT hybrid drugs for specific target tissues. The increased competition will change the global BT market fundamentally and a re-organisation according to large indication groups, such as therapeutic and cosmetic applications, might occur. PMID:26559824

  3. Intramural Injection with Botulinum Toxin Type A in Piglet Esophagus. The Influencer on Maximum Load and Elongation

    DEFF Research Database (Denmark)

    Pedersen, Mark Ellebæk; Qvist, Niels; Schrøder, Henrik Daa;

    2015-01-01

    receiving 2, 4, or 8 units/kg of BTX-A or isotonic saline (placebo). After a 1-hour of rest the esophagus was harvested and subjected to a stretch-tension test and histological examination to assess changes in the density of presynaptic vesicles in the nerve cells. Results Overall, 9 of the 52 animals were...... excluded from analysis due to problems with the stretch-tension test or death from anesthesia. The maximum loads were higher in the BTX-A groups (2 units/kg: +2.1 N; 4 units/kg: +1.3 N; 8 units/kg: +1.9 N) than the placebo (p = 0.046). There were no significant differences in percentage elongation......, or histology. Conclusions This study demonstrated that injection of 2 units/kg BTX-A into a nonanastomosed esophageal wall resulted in a modest increase in the maximum load achieved before bursting; this may be due to the muscle-relaxant effect of BTX-A. BTX-A injection produced no significant effects...

  4. A型肉毒毒素注射除皱致面部表情异常的临床研究%Clinical research of facial abnormal expressions caused by Botulinum toxin A injection

    Institute of Scientific and Technical Information of China (English)

    孙瑛; 孙玉萍; 于波; 白秀文

    2012-01-01

    Objective Observing characteristics of facial abnormal expressions caused by Botulinum toxin A injection. Through communication skills, injection drug selection, injection skills to avoid or reduce the adverse events, reduce the incidence of the medical disputes . Methods The patients were divided into crow's-feet groups,Look-up wrinkle groups, glabellum wrinkle groups , Respectively observed the chara-cteristics of abnormal expressions.according to the results, selecting clinical skills.Results To reduce the incidence of the medical disputes,it is necessary that fully communication before injection , legal botulinum toxin , clinical skills and remedial measure after injection. Conclusion Although botulinum toxin injection is simple to implement and effective, the aesthetic doctor must pay attention to the selection of preoperative indication , good communication skills in injection, summarizing experience.%目的:观察A型肉毒毒素注射除皱致面部表情异常的发生特点,从沟通技巧、注射药物选择、注射技巧等方面避免或减轻该不良反应的发生,减少由此而引起的医疗纠纷.方法:将接受注射除皱治疗的患者分为鱼尾纹组、眉间纹组、额纹组,分别观察各组出现表情异常的特点,有针对地运用临床技巧.结果:注射前充分沟通、使用正规合法的肉毒毒素制品、注射部位与剂量的巧妙结合及注射后及时采取有效的补救措施,可大大降低注射后表情异常的发生.结论:A型肉毒毒素注射美容操作简单,效果立竿见影,但美容主诊医生切不可麻痹大意,应注意术前适应证的严格选择及良好沟通,在注射技巧上总结经验,方能将注射后表情异常的不良反应降到最低.

  5. Tetanus: Pathophysiology, Treatment, and the Possibility of Using Botulinum Toxin against Tetanus-Induced Rigidity and Spasms

    Directory of Open Access Journals (Sweden)

    Bjørnar Hassel

    2013-01-01

    Full Text Available Tetanus toxin, the product of Clostridium tetani, is the cause of tetanus symptoms. Tetanus toxin is taken up into terminals of lower motor neurons and transported axonally to the spinal cord and/or brainstem. Here the toxin moves trans-synaptically into inhibitory nerve terminals, where vesicular release of inhibitory neurotransmitters becomes blocked, leading to disinhibition of lower motor neurons. Muscle rigidity and spasms ensue, often manifesting as trismus/lockjaw, dysphagia, opistotonus, or rigidity and spasms of respiratory, laryngeal, and abdominal muscles, which may cause respiratory failure. Botulinum toxin, in contrast, largely remains in lower motor neuron terminals, inhibiting acetylcholine release and muscle activity. Therefore, botulinum toxin may reduce tetanus symptoms. Trismus may be treated with botulinum toxin injections into the masseter and temporalis muscles. This should probably be done early in the course of tetanus to reduce the risk of pulmonary aspiration, involuntary tongue biting, anorexia and dental caries. Other muscle groups are also amenable to botulinum toxin treatment. Six tetanus patients have been successfully treated with botulinum toxin A. This review discusses the use of botulinum toxin for tetanus in the context of the pathophysiology, symptomatology, and medical treatment of Clostridium tetani infection.

  6. Botulinum toxin in the management of sialorrhoea in acquired brain injury

    LENUS (Irish Health Repository)

    Carroll, A

    2016-06-01

    Sialorrhoea as a consequence of severe acquired brain injury can significantly negatively impact on quality of life. Medications used in its management have many side effects which can cause problems in the severely disabled. Botulinum toxin is an effective treatment of sialorrhoea in a number of neurological conditions but may also have a role to play in the management of sialorrhoea following severe ABI. We report on 4 cases of sialorrhoea following acquired brain injury causing a variety of problems, whose parotid glands were injected with Botulinum toxin type A (Dysport) 50mu each, under ultrasound guidance. All cases had a clinically and statistically significant reduction in drooling as measured by the teacher drooling scale (p=0.005) and carers Visual Analogue Scale (p=0.012). There were no side effects reported. Botulinum toxin is an effective treatment for sialorrhoea associated with acquired brain injury.

  7. Toxin yet not toxic: Botulinum toxin in dentistry.

    Science.gov (United States)

    Archana, M S

    2016-04-01

    Paracelsus contrasted poisons from nonpoisons, stating that "All things are poisons, and there is nothing that is harmless; the dose alone decides that something is a poison". Living organisms, such as plants, animals, and microorganisms, constitute a huge source of pharmaceutically useful medicines and toxins. Depending on their source, toxins can be categorized as phytotoxins, mycotoxins, or zootoxins, which include venoms and bacterial toxins. Any toxin can be harmful or beneficial. Within the last 100 years, the perception of botulinum neurotoxin (BTX) has evolved from that of a poison to a versatile clinical agent with various uses. BTX plays a key role in the management of many orofacial and dental disorders. Its indications are rapidly expanding, with ongoing trials for further applications. However, despite its clinical use, what BTX specifically does in each condition is still not clear. The main aim of this review is to describe some of the unclear aspects of this potentially useful agent, with a focus on the current research in dentistry. PMID:27486290

  8. Thickened saliva after effective management of drooling with botulinum toxin A.

    NARCIS (Netherlands)

    Erasmus, C.E.; Hulst, K. van; Hoogen, F.J.A. van den; Limbeek, J. van; Roeleveld, N.; Veerman, E.C.; Rotteveel, J.J.; Jongerius, P.H.

    2010-01-01

    AIM: The aim of this study was to evaluate the rheological properties of saliva after submandibular botulinum toxin type A (BoNT-A) injections. METHOD: We enrolled 15 children (11 males and six females; age range 3-17 y, mean age 9 y 10 mo) diagnosed with spastic (n=9) or dyskinetic (n=6) quadripleg

  9. Thickened saliva after effective management of drooling with botulinum toxin A

    NARCIS (Netherlands)

    C.E. Erasmus; K. van Hulst; F.J. van den Hoogen; J. van Limbeek; N. Roeleveld; E.C.I. Veerman; J.J. Rotteveel; P.H. Jongerius

    2010-01-01

    Aim: The aim of this study was to evaluate the rheological properties of saliva after submandibular botulinum toxin type A (BoNT-A) injections. Method: We enrolled 15 children (11 males and six females; age range 3-17y, mean age 9y 10mo) diagnosed with spastic (n=9) or dyskinetic (n=6) quadriplegic

  10. Thickened Saliva after Effective Management of Drooling with Botulinum Toxin A

    Science.gov (United States)

    Erasmus, Corrie E.; van Hulst, Karen; van den Hoogen, Frank J. A.; van Limbeek, Jacques; Roeleveld, Nel; Veerman, Enno C. I.; Rotteveel, Jan J.; Jongerius, Peter H.

    2010-01-01

    Aim: The aim of this study was to evaluate the rheological properties of saliva after submandibular botulinum toxin type A (BoNT-A) injections. Method: We enrolled 15 children (11 males and six females; age range 3-17y, mean age 9y 10mo) diagnosed with spastic (n=9) or dyskinetic (n=6) quadriplegic cerebral palsy (CP); Gross Motor Function…

  11. Botulinum Toxin Type A Injection Combined With Cast Immobilization for Treating Recurrent Peroneal Spastic Flatfoot Without Bone Coalitions: A Case Report and Review of the Literature.

    Science.gov (United States)

    Xu, Jian; Muhammad, Hassan; Wang, Xu; Ma, Xin

    2015-01-01

    Peroneal spastic flatfoot is an uncommon condition. It often presents as a rigid and usually painful valgus deformity in the hindfoot with peroneal muscles spasms. Although tarsal coalition is an important cause, a few patients have not undergone bone coalitions. We describe a 27-year-old female who experienced recurrent peroneal spastic flatfoot after an injury. She was treated successfully with a combination of botulinum toxin type A and immobilization of the foot in a neutral position with a cast. After 3 years, the condition had not recurred, and she was pain free and walked normally, with no increase in muscle tone. This unique treatment could be of potential use to treat many patients with such conditions.

  12. An aptamer beacon responsive to botulinum toxins.

    Science.gov (United States)

    Bruno, John G; Richarte, Alicia M; Carrillo, Maria P; Edge, Allison

    2012-01-15

    Sixty candidate DNA aptamers were developed against botulinum neurotoxin (BoNT) type A light chain (LC) from ten rounds of selection, resulting in several identical sequences. Secondary structures of the identical aptamers were compared to structures of previously reported BoNT A DNA aptamers. A series of ten candidate loop structures were selected from this comparison as potential binding pockets and aptamer beacons. These candidate beacons were synthesized with 5'-TYE 665 and 3'-Iowa Black quencher labels for comparison of fluorescence levels as a function of BoNT A LC concentration. Only three of the ten candidates exhibited any fluorescence response to increasing levels of BoNT A LC. However, of the two most responsive candidates, one represented a subset loop of the larger more intensely fluorescent double-looped structure, designated Beacon 10. This beacon yielded a lower limit of detection of 1 ng/mL in buffer using a spectrofluorometer and a portable handheld fluorometer, but also responded substantially to BoNT A, B, E holotoxins and heavy or light chain components even in a dilute soil suspension, but not in 50% human serum. Beacon 10 did not respond strongly to a variety of other divergent peptides, suggesting that it is relatively specific to the level of botulinum toxins and is only useful for environmental testing. Beacon 10 also shared short sequence segments with other published BoNT aptamer DNA sequences, suggesting that these may be points of physical contact between the aptamers and BoNTs.

  13. Treatment of Raynaud's phenomenon with botulinum toxin type A.

    Science.gov (United States)

    Zhang, Xiaolong; Hu, Yong; Nie, Zhiyu; Song, Ye; Pan, Yougui; Liu, Ying; Jin, Lingjing

    2015-07-01

    Raynaud's phenomenon (RP), an episodic vasospasm of the peripheral arteries, is quite common in general population. The current therapies of RP are limited by efficacy, side effects, and polypharmacy concerns. Botulinum toxin type A (BTX-A) local injections have been reported for the treatment of RP, but the injection sites, concentration and dose of BTX-A were different from each other in previous trials. In addition, so far, there have been no reports concerning local injection of BTX-A in Asian RP patients. Ten patients with RP in China were included in this retrospective study. All the patients had intractable pain and were non-responsive to conservative and/or medical therapy. A patterned BTX-A injection was performed in RP patients, guided by ultrasonography. BTX-A was injected as 20 u/ml devoid of preservatives. Outcomes were measured by ultrasonography, surface temperature, visual analog scale (VAS) for clinical symptoms (pain, numbness, stiffness and swelling), and changes in ulcers or gangrene. Overall, a great improvement in artery flow velocity (P < 0.01), surface temperature (P < 0.01), ulcer and VAS for clinical symptoms, was observed after BTX-A local injection. Complications were very rarely found, and no patients complained of hand weakness and bruise. BTX-A patterned injection guided by ultrasonography might be a useful therapeutic tool in the management of intractable RP.

  14. FDA Approves First Botulism Antitoxin for Use in Neutralizing All Seven Known Botulinum Nerve Toxin Serotypes

    Science.gov (United States)

    ... Antitoxin for use in neutralizing all seven known botulinum nerve toxin serotypes Product to be stored in Strategic National ... antibody fragments that neutralize all of the seven botulinum nerve toxin serotypes known to cause botulism. Botulism is a ...

  15. Improving botulinum toxin therapy for palmar hyperhidrosis: wrist block and technical considerations.

    Science.gov (United States)

    de Almeida, A R; Kadunc, B V; de Oliveira, E M

    2001-01-01

    Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscle weakness secondary to botulinum toxin diffusion and the possibility of antibody production. All these problems limit the number of patients treated. The author's suggestion is to treat only the dominant hand, after performing a wrist block. The use of a device adapted from a cartridge rubber may help to control the injection depth and the risk of muscular weakness. PMID:11231239

  16. Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

    Science.gov (United States)

    Mor, Niv; Tang, Christopher; Blitzer, Andrew

    2016-09-01

    Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. PMID:27143711

  17. Botulinum Toxin Treatment for Limb Spasticity in Childhood Cerebral Palsy

    Science.gov (United States)

    Pavone, Vito; Testa, Gianluca; Restivo, Domenico A.; Cannavò, Luca; Condorelli, Giuseppe; Portinaro, Nicola M.; Sessa, Giuseppe

    2016-01-01

    CP is the most common cause of chronic disability in childhood occurring in 2–2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX) has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children. This report highlights the utility of BTX in the treatment of cerebral palsy in children. We include techniques for administration, side effects, and possible resistance as well as specific use in the upper and lower limbs muscles. PMID:26924985

  18. Botulinum toxin: application, safety, and limitations.

    Science.gov (United States)

    Bigalke, Hans

    2013-01-01

    Botulinum neurotoxin type A (BoNT/A), despite its high toxicity, is approved for therapy of many neurological (e.g., dystonia, spasticity) and non-neurological (e.g., achalasia, hyperhidrosis) disorders. Its mode of action is well understood. This has led to more and more indications (e.g., pain, gastrointestinal and urologic disorders), in which the toxin can reduce disturbing symptoms. In general the application is safe (pharmacological index 20-100, depending on indication). Few unwanted reactions may occur. In worst cases BoNT treated patients may develop neutralizing antibodies. These patients are excluded from further treatment. A more recently approved second serotype (BoNT/B) could be effective in those secondary non-responders, however, due to less potency in humans higher doses have to be applied leading to an only transient successful treatment. Other serotypes as BoNT/A and B, e.g., BoNT/C should be approved as medicines. PMID:23239359

  19. Botulinum Toxin Type A Injections in the Psoas Muscle of Children with Cerebral Palsy: Muscle Atrophy after Motor End Plate-Targeted Injections

    Science.gov (United States)

    Van Campenhout, Anja; Verhaegen, Ann; Pans, Steven; Molenaers, Guy

    2013-01-01

    MEP targeting during BoNT-A injections has been demonstrated to improve outcome. Two injection techniques of the psoas muscle--proximal MEP targeting versus a widely used more distal injection technique--are compared using muscle volume assessment by digital MRI segmentation as outcome measure. Method: 7 spastic diplegic children received…

  20. Attempts to identify Clostridium botulinum toxin in milk from three experimentally intoxicated Holstein cows

    Science.gov (United States)

    Moeller, R.B.; Puschner, B.; Walker, R.L.; Rocke, T.E.; Smith, S.R.; Cullor, J.S.; Ardans, A.A.

    2009-01-01

    Three adult lactating Holstein cows were injected in the subcutaneous abdominal vein with 175 ng/kg of body weight of Clostridium botulinum type C toxin (451 cow median toxic doses) to determine if this botulinum toxin crosses the blood-milk barrier. Whole blood (in sodium heparin) and clotted blood serum samples were taken at 0 min, 10 min, and 3, 6, 9, and 12 h postinoculation. Milk samples were taken at 0 min and at 3, 6, 9 and 12 h postinoculation. All samples were tested for the presence of the toxin using the mouse bioassay and immunostick ELISA test. The immunostick ELISA identified the toxin in whole blood and the mouse bioassay identified the toxin in serum at all times examined in all 3 animals. Toxin was not identified by either detection method in milk samples collected from the 3 animals. From these results, it appears that Clostridium botulinum type C toxin does not cross from the blood to the milk in detectable concentrations. ?? American Dairy Science Association, 2009.

  1. Interaction of Botulinum Toxin with the Epithelial Barrier

    Directory of Open Access Journals (Sweden)

    Yukako Fujinaga

    2010-01-01

    Full Text Available Botulinum neurotoxin (BoNT is a protein toxin (~150 kDa, which possesses a metalloprotease activity. Food-borne botulism is manifested when BoNT is absorbed from the digestive tract to the blood stream and enters the peripheral nerves, where the toxin cleaves core proteins of the neuroexocytosis apparatus and elicits the inhibition of neurotransmitter release. The initial obstacle to orally ingested BoNT entering the body is the epithelial barrier of the digestive tract. Recent cell biology and molecular biology studies are beginning to elucidate the mechanism by which this large protein toxin crosses the epithelial barrier. In this review, we provide an overview of the structural features of botulinum toxins (BoNT and BoNT complex and the interaction of these toxins with the epithelial barrier.

  2. Botulinum toxin for the treatment of myofascial pain syndromes involving the neck and back: a review from a clinical perspective.

    Science.gov (United States)

    Climent, José M; Kuan, Ta-Shen; Fenollosa, Pedro; Martin-Del-Rosario, Francisco

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  3. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    Directory of Open Access Journals (Sweden)

    José M. Climent

    2013-01-01

    Full Text Available Introduction. Botulinum toxin inhibits acetylcholine (ACh release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources of variability that could explain these differences in the results. Material and Methods. We performed a content analysis of the clinical trials and systematic reviews of MPS. Results and Discussion. Sources of differences in studies were found in the diagnostic and selection criteria, the muscles injected, the injection technique, the number of trigger points injected, the dosage of botulinum toxin used, treatments for control group, outcome measures, and duration of followup. The contradictory results regarding the efficacy of botulinum toxin A in MPS associated with neck and back pain do not allow this treatment to be recommended or rejected. There is evidence that botulinum toxin could be useful in specific myofascial regions such as piriformis syndrome. It could also be useful in patients with refractory MPS that has not responded to other myofascial injection therapies.

  4. Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders

    OpenAIRE

    Siro Luvisetto; Parisa Gazerani; Carlo Cianchetti; Flaminia Pavone

    2015-01-01

    Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spastic...

  5. Botulinum Toxin Treatment of Neuropathic Pain.

    Science.gov (United States)

    Mittal, Shivam Om; Safarpour, Delaram; Jabbari, Bahman

    2016-02-01

    Neuropathic pain (NP), a common form of human pain, often poorly responds to analgesic medications. In this review the authors discuss the pathophysiology and conventional treatment of neuropathic pain and provide evidenced-based statements on the efficacy of botulinum neurotoxins (BoNTs) in this form of pain. The level of efficacy for BoNT treatment in each category of NP is defined according to the published guidelines of the American Academy of Neurology. The data indicate that BoNT treatment (most of the literature is with onabotulinumtoxinA) is effective (level A evidence) in postherpetic neuralgia and trigeminal neuralgia. It is probably effective (level B) in posttraumatic neuralgia and painful diabetic neuropathy. The data on complex regional pain syndrome, carpal tunnel syndrome, occipital neuralgia, and phantom limb pain are preliminary and await conduction of randomized, blinded clinical trials. Much remains to be learned about the most-effective dosage and technique of injection, optimum dilutions, and differences among BoNTs in the treatment of neuropathic pain. PMID:26866499

  6. Botulinum toxin A inhibits salivary secretion of rabbit submandibular gland

    Institute of Scientific and Technical Information of China (English)

    Xiao-Feng Shan; Hui Xu; Zhi-Gang Cai; Li-Ling Wu; Guang-Yan Yu

    2013-01-01

    Botulinum toxin A (BTXA) has been used in several clinical trials to treat excessive glandular secretion;however, the precise mechanism of its action on the secretory function of salivary gland has not been fully elucidated. In this study, we aimed to investigate the effect of BTXA on secretion of submandibular gland in rabbits and to identify its mechanism of action on the secretory function of salivary gland. At 12 weeks after injection with 5 units of BTXA, we found a significant decrease in the saliva flow from submandibular glands, while the salivary amylase concentration increased. Morphological analysis revealed reduction in the size of acinar cells with intracellular accumulation of secretory granules that coalesced to form a large ovoid structure. Expression of M3-muscarinic acetylcholine receptor (M3 receptor) and aquaporin-5 (AQP5) mRNA decreased after BTXA treatment, and distribution of AQP5 in the apical membrane was reduced at 1, 2 and 4 weeks after BTXA injection. Furthermore, BTXA injection was found to induce apoptosis of acini. These results indicate that BTXA decreases the fluid secretion of submandibular glands and increases the concentration of amylase in saliva. Decreased expression of M3 receptor and AQP5, inhibition of AQP5 translocation, and cell apoptosis might involve in BTXA-reduced fluid secretion of submandibular glands.

  7. Botulinum toxin A inhibits salivary secretion of rabbit submandibular gland.

    Science.gov (United States)

    Shan, Xiao-Feng; Xu, Hui; Cai, Zhi-Gang; Wu, Li-Ling; Yu, Guang-Yan

    2013-12-01

    Botulinum toxin A (BTXA) has been used in several clinical trials to treat excessive glandular secretion; however, the precise mechanism of its action on the secretory function of salivary gland has not been fully elucidated. In this study, we aimed to investigate the effect of BTXA on secretion of submandibular gland in rabbits and to identify its mechanism of action on the secretory function of salivary gland. At 12 weeks after injection with 5 units of BTXA, we found a significant decrease in the saliva flow from submandibular glands, while the salivary amylase concentration increased. Morphological analysis revealed reduction in the size of acinar cells with intracellular accumulation of secretory granules that coalesced to form a large ovoid structure. Expression of M3-muscarinic acetylcholine receptor (M3 receptor) and aquaporin-5 (AQP5) mRNA decreased after BTXA treatment, and distribution of AQP5 in the apical membrane was reduced at 1, 2 and 4 weeks after BTXA injection. Furthermore, BTXA injection was found to induce apoptosis of acini. These results indicate that BTXA decreases the fluid secretion of submandibular glands and increases the concentration of amylase in saliva. Decreased expression of M3 receptor and AQP5, inhibition of AQP5 translocation, and cell apoptosis might involve in BTXA-reduced fluid secretion of submandibular glands. PMID:24158141

  8. Centrifugal microfluidic platform for ultrasensitive detection of Botulinum Toxin

    Science.gov (United States)

    Botulinum neurotoxin – a global public health threat and category A bioterrorism agent - is the most toxic substance known and one of the most challenging toxins to detect due to its lethality at extremely low concentrations. Hence the live-mouse bioassay because of its superior sensitivity, remains...

  9. Calf muscle volume estimates: Implications for Botulinum toxin treatment?

    DEFF Research Database (Denmark)

    Bandholm, Thomas Quaade; Sonne-Holm, Stig; Thomsen, Carsten;

    2007-01-01

    An optimal botulinum toxin dose may be related to the volume of the targeted muscle. We investigated the suitability of using ultrasound and anthropometry to estimate gastrocnemius and soleus muscle volume. Gastrocnemius and soleus muscle thickness was measured in 11 cadaveric human legs, using...

  10. Evaluating Functional Outcomes of Botulinum Toxin Type A Injection Combined with Occupational Therapy in the Upper Limbs of Children with Cerebral Palsy: A 9-Month Follow-Up from the Perspectives of Both Child and Caregiver.

    Directory of Open Access Journals (Sweden)

    Yu-Ching Lin

    Full Text Available To assess the effectiveness of combining botulinum toxin type A (BoNT-A with functional occupational therapy (OT at 9-month follow-up in children with cerebral palsy (CP with bilateral upper limb impairments from the perspectives of both child and caregiver.Twelve children with CP and their caregivers were assessed across 5 time points over 9 months based on the ICF after BoNT-A injection and functional OT in this open-label study.Significant differences were found across the 5 time points (p < .05 for both grasp and visual-motor integration with small effects (effect sizes = 0.12-0.24 and the self-care capability and performance of social function (p < .05. However, based on the effect sizes (0.02-0.14, no significant effects were found at the 4 post-test time points. Small effects were found on the psychological domain (effect sizes = 0.25-0.37 and environmental domains (effect size = 0.27 at follow-ups.Combining a BoNT-A injection with OT not only reduced the muscle tone and increased ROM but also improved the upper limb function and self-care capability in children with CP. More importantly, these effects persisted for up to 9 months. Functional OT extends the effectiveness of a BoNT-A injection.

  11. Jaw-opening oromandibular dystonia secondary to Wilson's Disease treated with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Hélio A.G. Teive

    2012-06-01

    Full Text Available We have reported a case series of five patients with jaw-opening oromandibular dystonia secondary to Wilson's disease (WD, in which the patients were treated with botulinum toxin type A (BTX-A. In all cases, dystonia score was partially reduced three weeks after injections. The most common side effect was transient mild dysphagia. This preliminary study showed that jaw-opening oromandibular dystonia in WD may be partially responsive to the use of BTX-A.

  12. Clinical and image improvement of Raynaud's phenomenon after botulinum toxin type A treatment.

    Science.gov (United States)

    Zhao, HongMei; Lian, YaJun

    2015-08-01

    Raynaud's phenomenon is often accompanied by pain, digital ulceration and compromised daily activities. Pharmacological therapy or sympathectomies have been administered to diminish these symptoms but existing treatments are not invariably efficacious. A recent case series has described the use of botulinum toxin type A in the treatment of Raynaud's phenomenon. We report two patients with severe or mild Raynaud's phenomenon who were injected with BTX-A; both of whom experienced clinical and image improvement after treatment.

  13. A Beautician’s Dystonia: Long-Lasting Effect of Botulinum Toxin

    Directory of Open Access Journals (Sweden)

    Siria Di Martino

    2014-01-01

    Full Text Available Treatment options for dystonia are not curative but symptomatic; the treatment of choice for focal dystonias is repeated botulinum toxin injections. Here, we present the case of a 46-year-old beautician with focal dystonia in her left hand that affected her ability to work. Pharmacological treatment with clonazepam and gabapentin failed to resolve her symptoms and was discontinued due to side effects (sleepiness, gastrointestinal disorders. Intramuscular injection of botulinum toxin (incobotulinumtoxinA, Xeomin into the extensor digitorum communis (35 U, flexor carpi radialis (35 U, and flexor digitorum superficialis (30 U muscles resulted in complete resolution of symptoms at clinical assessments at 1, 3, 6, and 10 months after the injections, confirmed by the results of surface electromyography 10 months after treatment. The patient was able to work again 1 month after treatment. No reinjection has been necessary at the last evaluation (12 months after treatment. In conclusion, botulinum toxin is an effective treatment for focal dystonia that can have long-lasting effects and can improve patients’ ability to work and quality of life.

  14. High-dose botulinum toxin type A local injection therapy for axillary hyperhidrosis%大剂量A型肉毒毒素局部注射治疗腋部多汗症

    Institute of Scientific and Technical Information of China (English)

    高扬; 宋军; 李虎; 鲁元刚

    2011-01-01

    目的 探讨大剂量肉毒毒素治疗腋部多汗症的长期疗效和重复治疗的疗效.方法 92例患者随机分为两组:小剂量组为每侧腋部皮内注射生理盐水稀释的A型肉毒毒素50U;大剂量组为每侧腋部皮内注射生理盐水稀释的A型肉毒毒素200U;随访3~29个月,观察两组并发症,并建立两组等级资料,经χ2 检验,评价两组患者疗效差异.结果 两组疗效进行对照分析,经过统计学处理分析,认为对于腋部多汗症的患者,小剂量与大剂量的BTXA治疗方法的疗效间隔时间,差异有统计学意义.结论 大剂量A型肉毒毒素能够显著延长腋部多汗症复发间隔时间.%Objective Evaluate the long-term effectiveness of high-dose botulinum toxin therapy in axillary hyperhidrosis, the response to repeated treatment, and the possible side effects. Methods Totally 92 patients with axillary hyperhidrosis were randomly divided into two groups. One group were injected with low-dose botulinum toxin A( BTX-A ), 50 U was injected per axilla. Another group were injected with high-dose BTX-A. A total dose of 200 U of BTX-A was used per axilla. Patients were followed up for periods up to 29 months. To investigate the effect of two methods, we analyzed two ranked data by rank sum test and x2 test to judge the disparities of the therapeutic effect. Results The results showed that the relapse-free interval of two groups with axillary hyperhidrosis was significant difference through the statistical analysis. Conclusion High-dose BTX-A treatment is capable of prolonging the antihidrotic effect of intracutaneous.

  15. Clinical efficacy of botulinum toxin type A injected by BellaVita in treatment of focal hyperhidrosis%A型肉毒毒素治疗局部多汗症的临床效果

    Institute of Scientific and Technical Information of China (English)

    陈凤超; 杨俊革; 夏秉成; 侯俊杰; 刘林嶓

    2016-01-01

    目的 探讨A型肉毒毒素治疗多汗症的临床效果.方法 观察28例多汗症患者132个部位治疗效果.用微碘-淀粉试验判定多汗症程度及范围.将A型肉毒毒素加入水光注射仪,单侧腋窝、手掌及脚掌注射剂量各50 U,额部30 U.注射后1周、2周和每月复查1次,随访8个月.每次随访根据微碘-淀粉试验的客观效果评价及主观效果评价得出分值,再进行综合效果评价.结果 注射前综合效果评价(1.34±3.94)分,A型肉毒毒素注射后1周综合效果评价(23.21±9.44)分,注射后1个月(92.41±11.95)分,2个月(98.21±5.60)分,3个月(95.98±5.94)分,4个月(86.61±10.17)分.与注射前比较,差异有统计学意义(P<0.05).之后效果慢慢减退,最长疗效维持可达8个月,综合效果评价(4.46±6.98)分,与注射前比较,差异无统计学意义(P>0.05).注射后6个月和注射后l周比较;差异无统计学意义(P>0.05).结论 A型肉毒毒素通过水光注射仪给药途径治疗局部多汗症见效快,疗效确切.%Objective To explore the new way of administration and clinical effect of botulinum toxin A in the treatment of focal hyperhidrosis.Methods The clinical efficacy was observed in 132 sites of 28 patients with focal hyperhidrosis,and the degree and range of focal hyperhidrosis were determined by the minor iodine-starch test.50 U of botulinum toxin A was injected in unilateral axillary,palms and soles with BellaVita instrument and 30 U for forehead.Each patient was followed-up in 1 week,2 weeks and every month after injection for 8 months.According to the results of the minor iodine-starch test the objective effect and evaluation score were obtained,and the comprehensive effect evaluation score was calculated with the objective effect evaluation score and the subjective effect evaluation score in each follow-up.Results The comprehensive effect evaluation score before injection of botulinum toxin A was 1.34±3.94,and that after injection was 23

  16. Function of the Masseter Injection of Botulinum Toxin and Buccal Fat Pad Excision Combined in Facial Profile%肉毒素咬肌注射和颊脂垫切除术联合应用在面部改形中的作用

    Institute of Scientific and Technical Information of China (English)

    姚海鸥

    2015-01-01

    Objective To investigate the masseter injection of botulinum toxin and buccal fat pad excision combined in facial profile effect. Methods In our hospital from May 2013 to September 2014, patients need facial shape modification of the 50 cases as the object, the use of botulinum toxin injection in the masseter muscle and the buccal fat pad excision combined with surgery observed the clinical effect. Results To require facial shape modification of 50 patients of botulinum toxin injection masseter and buccal fat pad excision treatment, patients with facial were improved, and the infection rate of 2%. Conclusion The use of botulinum toxin injection of masseter and buccal fat pad excision in facial shape in clinical effect is obvious.%目的:探讨肉毒素咬肌注射和颊脂垫切除术联合应用在面部改形中的效果。方法选取我院2013年5月~2014年9月收治的需要面部改形的患者50例为对象,使用肉毒素咬肌注射和颊脂垫切除术联合进行手术,观察其临床作用。结果对需要面部改形的50例患者进行肉毒素咬肌注射联合颊脂垫切除术进行治疗后,患者面型均得到改善,感染率为2%。结论使用肉毒素咬肌注射联合颊脂垫切除术在面部改形中的临床效果明显。

  17. Correção de estrabismo paralítico por injeção de toxina botulínica Management of paralytic strabismus by injection of botulinum toxin

    Directory of Open Access Journals (Sweden)

    Raquel Wattiez

    2000-02-01

    Full Text Available Objetivo: Avaliar a ação da toxina botulínica em paralisias adquiridas de VI e III nervos. Pacientes e métodos: Foram tratados com toxina botulínica 15 pacientes, com diagnóstico de paralisia de VI e III nervos, aguda ou crônica. Foram estudados de forma prospectiva, durante os meses de agosto de 1998 a maio de 1999. O estudo incluiu, além da avaliação do estrabismo, avaliação oftalmológica completa. Os pacientes foram acompanhados por um período de 2 a 7 meses após a última aplicação. Resultados: Onze pacientes (73% apresentaram paralisias do VI nervo e 4 pacientes (27%, paralisias de III nervo. Seis casos foram agudos (40% e 9 casos (60%, crônicos. Cinco dos 6 casos agudos (83% conseguiram controlar o desvio com a toxina botulínica como único tratamento e obter fusão. Dos 9 casos crônicos, 2 casos (22% corrigiram o desvio só com a toxina, os outros 7, além da aplicação, foram submetidos à cirurgia, dos quais 4 casos (46% foram corrigidos e os outros 3 casos (32% não. Conclusão: Concluímos que nos casos em que houve força muscular residual, após a paralisia, e bom potencial de fusão, a toxina botulínica foi o melhor tratamento, pois foi possível controlar o desvio e obter fusão, sem cirurgia.Purpose: To evaluate the treatment by injection of botulinum toxin in acquired sixth and third nerve palsies. Methods: Fifteen patients were treated with botulinum toxin. They were studied prospectively during nine months, between August, 1998 and May, 1999. In addition to the strabismus examination, a complete ophthalmological evaluation was performed. The patients were followed for 2 to 7 months after the last injection or surgical procedure. Results: Eleven patients (73% presented with sixth nerve palsy and four (27% with third nerve palsy. Six cases were acute (40% and 9 cases (60% were chronic. Five acute cases (83% obtained ocular alignment and controlled the deviation with toxin. Two of nine chronic cases (22

  18. Type A botulinum toxin: a new treatment for axillary and palmar hyperhidrosis.

    Science.gov (United States)

    Rusciani, Luigi; Severino, Enzo; Rusciani, Antonio

    2002-09-01

    Hyperhidrosis is an invalidating condition, and one that is difficult to treat. It is characterized by an excessive and uncontrolled production of sweat by the sweat glands, often causing psychological, social, and occupational problems for the patient. Hyperhidrosis can be distinguished in two forms: idiopathic (of unknown etiology), or secondary, due to an alteration of the endocrine system (ex: hyperthyroidism, neuropathy, neoplasia etc.) It is found in about 0.3-0.5% of the population and can be localized (axillary, palmar, plantar, facial) or diffused. The subcutaneous injection of type A botulinum toxin, until now used only for the treatment of blepharospasm or hemifacial spasm, has shown to be a useful treatment for localized hyperhidrosis. The objective of the authors is to evaluate the therapeutic efficacy, safety, and management of botulinum toxin treatment in patients affected with axillary or palmar hyperhidrosis resistant to conventional therapies. PMID:12847738

  19. Botulinum Toxin as a Novel Addition to Anti-Arthritis Armamentarium

    Directory of Open Access Journals (Sweden)

    Hamid Namazi

    2005-01-01

    Full Text Available Osteoarthritis is the most common joint disease and is among the most frequent health problems for middle aged and older people. There is strong evidence that proinflammatory cytokines contribute to cartilage degradation in osteoarthritis. Interleukin-1 is the prototypical proinflammatory cytokine implicated in the pathogenesis of cartilage matrix degeneration. Results from studies in animal models provide stronger evidence implicating a role for interleukin-1 in the pathogenesis of matrix loss in osteoarthritis. These include the induction of proteoglycan loss by intraarticular injection of interleukin-1 and the capacity of the inhibitor of interleukin-1, interleukin-1 receptor antagonist (IL-1 ra, to slow the progression of cartilage loss in animal models of osteoarthritis. The botulinum toxin has been used in many clinical situations such as: cerebral palsy, headache, cosmesis and etc. Moreover, there is evidence that botulinum toxin specifically inhibits Rho GTPase by ADP-ribosylation of aminoacid ASn-41. Rho GTPase is necessary for activation of interleukin-1 inflammation pathway. Based on previously mentioned evidence we suggest, intraarticular injection of the botulinum toxin may be a useful therapy in osteoarthritis.

  20. Botulinum Toxin and Gastrointestinal Tract Disorders: Panacea, Placebo, or Pathway to the Future?

    OpenAIRE

    Lacy, Brian E.; Weiser, Kirsten; Kennedy, Abigail

    2008-01-01

    The history of botulinum toxin is fascinating. First recognized as the cause of botulism nearly 200 years ago, it was originally feared as a deadly poison. Over the last 30 years, however, botulinum toxin has been transformed into a readily available medication used to treat a variety of medical disorders. Interest in the use of botulinum toxin has been particularly strong for patients with spastic smooth muscle disorders of the gastrointestinal tract. Patients with achalasia, diffuse esophag...

  1. Botulinum toxin type A-a novel treatment for provoked vestibulodynia? Results from a randomized, placebo controlled, double blinded study

    DEFF Research Database (Denmark)

    Petersen, Christina Damsted; Giraldi, Annamaria; Lundvall, Lene;

    2009-01-01

    receive Botox (N = 32) or saline placebo (N = 32). Botulinum toxin A (20 I.E.) diluted in 0.5 mL saline or 0.5 mL saline was injected in the musculus bulbospongiosus at baseline. MAIN OUTCOME MEASURES: Pain was measured monthly on a visual analog scale (VAS) Likert scale. Sexual function was measured...

  2. Brain Metabolic Changes of Cervical Dystonia with Spinocerebellar Ataxia Type 1 after Botulinum Toxin Therapy.

    Science.gov (United States)

    Kikuchi, Akio; Takeda, Atsushi; Sugeno, Naoto; Miura, Emiko; Kato, Kazuhiro; Hasegawa, Takafumi; Baba, Toru; Konno, Masatoshi; Oshima, Ryuji; Watanuki, Shoichi; Hiraoka, Kotaro; Tashiro, Manabu; Aoki, Masashi

    2016-01-01

    We occasionally observe long-term remission of cervical dystonia after several botulinum toxin treatments. However, botulinum toxin transiently acts on neuromuscular junctions. We herein report that a cervical dystonia patient with spinocerebellar ataxia type 1 could have long-term remission as a result of the depression of hypermetabolism in the bilateral putamen and primary sensorimotor cortex after botulinum toxin therapy. We suggest that botulinum toxin impacts the central nervous system, causing prolonged improvement through the normalization of basal ganglia circuits in addition to its effects at neuromuscular junctions. PMID:27432104

  3. Botulinum toxin industry : is it a profitable industry to enter?

    OpenAIRE

    Salopek, Barbara

    2009-01-01

    This paper examines the botulinum toxin industry and is it profitable to enter. In particular, the paper aims to define whether the industry structure is attractive because an industry is considered profitable only if it has attractive structure. This has been explored through applying the Porter’s five forces framework which provides a good understanding of farces shaping the industry and thus help to define the industry structure. It has been shown that the BTX industry has b...

  4. Botulinum toxin for treating muscular temporomandibular disorders: a systematic review

    OpenAIRE

    Eduardo Machado; Lívia Zuchetto dos Santos; Lilian Gonçalves Custódio; Paulo Afonso Cunali

    2012-01-01

    OBJECTIVE: This study, through a systematic literature review, aims to analyze the effectiveness of Botulinum Toxin as a treatment for masticatory myofascial pain and muscles temporomandibular disorders (TMD). METHODS: Survey in research bases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and April 2011, with focus in randomized or quasi-randomized controlled clinical trials, blind or double-blind. RESULTS: After applying the inclusion criteria, 4 articles comp...

  5. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Thorley Megan

    2012-08-01

    Full Text Available Abstract Background Children with cerebral palsy (CP whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V, compared with standard therapy alone (cycle I, and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II. The regime of therapy will include serial casting, splinting and/or provision of orthoses, as indicated, combined with four sessions of goal directed occupational therapy or physiotherapy. Method/design This study is a double blind randomized controlled trial. Forty participants will be recruited. In cycle I, participants will be randomized to either a treatment group who will receive BoNT-A injections into selected upper and/or lower limb muscles, or a control group who will undergo sham injections. Both groups will receive occupational therapy and /or physiotherapy following injections. Groups will be assessed at baseline then compared at 4 and 16 weeks following injections or sham control. Parents, treating clinicians and assessors will be masked to group allocation. In cycle II, all participants will undergo intramuscular BoNT-A injections to selected upper and/or lower limb muscles, followed by therapy. The primary outcome measure will be change in parent ratings in identified areas of concern for their child’s care and comfort, using the Canadian Occupational Performance Measure (COPM. Secondary measures will include the Care and Comfort Hypertonicity Scale (ease of care, the Cerebral Palsy Quality of Life Questionnaire (CP QoL–Child (quality of life, the Caregiver Priorities and Child

  6. 贲门失弛缓症内镜下注射肉毒毒素与气囊扩张术疗效比较的系统评价%Endoscopic botulinum toxin injection versus pneumatic dilation in the management of achalasia

    Institute of Scientific and Technical Information of China (English)

    何继东; 王一平; 欧阳晓波

    2008-01-01

    目的 系统评价内镜下注射肉毒毒素与气囊扩张治疗贲门失弛缓症的有效性和安全性.方法 应用国际Cochrane协作网系统评价方法进行评价.结果 共纳人12个试验包括559例患者.Meta分析显示:(1)短期总有效率内镜下气囊扩张治疗优于内镜下注射肉毒毒素治疗(83.21%比71.27%,P<0.01).(2)长期总有效率内镜下气囊扩张治疗优于内镜下注射肉毒毒素治疗(54.59%比27.60%,P<0.01).(3)临床复发率内镜下注射肉毒毒素治疗高于内镜下气囊扩张治疗(55.66%比18.84%,P<0.01).(4)副作用及并发症发生率内镜下气囊扩张治疗高于内镜下注射肉毒毒素治疗(13.01%比1.35%,P<0.01).结论 目前的证据表明:内镜下注射肉毒毒素与气囊扩张均有较好的短期疗效和安全性,内镜下气囊扩张治疗在长期疗效上更优于内镜下注射肉毒毒素.%Objective To determine the effectiveness and safety of endoscopic botulinum toxin injection versus pneumatic dilation in treatment of achalasia.Methods A systematic review of all the relevant randomized controlled trials was performed according to international Cochrane Collaboration.Results Twelve trials involving 559 patients were included in the systematic review.Meta analysis showed:(1)Pneumatic dilation was superior to botulinum toxin injection in short term symptom relief(83.21% VS 71.27%.P=0.0007);(2)It was also superior to botulinum toxin injection in long term symptom relief(54.59% vs 27.60%,P=0.005);(3)The recurrent rate is lower in botulinum toxin injection than in pneumatic dilation(55.66% vs 18.84%,P<0.0001);(4)There were more side-effects and complications in pneumatic dilation than in botulinum toxin injection(13.01% VS 1.35%,P=0.0008).Conclusion The limited current evidence showed that endoscopic botulinum toxin injection and pneumatic dilation are safe and effective in the short term treatment for achalasia.Pneumatic dilation is more effective than endoscopic botulinum toxin

  7. Influence of Botulinum Toxin Therapy on Postural Control and Lower Limb Intersegmental Coordination in Children with Spastic Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Bernard Dan

    2013-01-01

    Full Text Available Botulinum toxin injections may significantly improve lower limb kinematics in gait of children with spastic forms of cerebral palsy. Here we aimed to analyze the effect of lower limb botulinum toxin injections on trunk postural control and lower limb intralimb (intersegmental coordination in children with spastic diplegia or spastic hemiplegia (GMFCS I or II. We recorded tridimensional trunk kinematics and thigh, shank and foot elevation angles in fourteen 3–12 year-old children with spastic diplegia and 14 with spastic hemiplegia while walking either barefoot or with ankle-foot orthoses (AFO before and after botulinum toxin infiltration according to a management protocol. We found significantly greater trunk excursions in the transverse plane (barefoot condition and in the frontal plane (AFO condition. Intralimb coordination showed significant differences only in the barefoot condition, suggesting that reducing the degrees of freedom may limit the emergence of selective coordination. Minimal relative phase analysis showed differences between the groups (diplegia and hemiplegia but there were no significant alterations unless the children wore AFO. We conclude that botulinum toxin injection in lower limb spastic muscles leads to changes in motor planning, including through interference with trunk stability, but a combination of therapies (orthoses and physical therapy is needed in order to learn new motor strategies.

  8. Use of Clostridium botulinum toxin in gastrointestinalmotility disorders in children

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    More than a century has elapsed since the identificationof Clostridia neurotoxins as the cause of paralyticdiseases. Clostridium botulinum is a heterogeneousgroup of Gram-positive, rod-shaped, spore-forming,obligate anaerobic bacteria that produce a potentneurotoxin. Eight different Clostridium botulinumneurotoxins have been described (A-H) and 5 of thosecause disease in humans. These toxins cause paralysisby blocking the presynaptic release of acetylcholine atthe neuromuscular junction. Advantage can be taken ofthis blockade to alleviate muscle spams due to excessiveneural activity of central origin or to weaken a musclefor treatment purposes. In therapeutic applications,minute quantities of botulinum neurotoxin type A areinjected directly into selected muscles. The Food andDrug Administration first approved botulinum toxin (BT)type A in 1989 for the treatment of strabismus andblepharospasm associated with dystonia in patients 12years of age or older. Ever since, therapeutic applicationsof BT have expanded to other systems, including thegastrointestinal tract. Although only a single fatalityhas been reported to our knowledge with use of BTfor gastroenterological conditions, there are significantcomplications ranging from minor pain, rash and allergicreactions to pneumothorax, bowel perforation andsignificant paralysis of tissues surrounding the injection(including vocal cord paralysis and dysphagia). Thiseditorial describes the clinical experience and evidencefor the use BT in gastrointestinal motility disorders inchildren.

  9. Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper

    Directory of Open Access Journals (Sweden)

    Imms Christine

    2010-07-01

    Full Text Available Abstract Background Use of Botulinum toxin-A (BoNT-A for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. There is now high-level evidence that upper limb BoNT-A injection, in combination with occupational therapy, improves outcomes in children with cerebral palsy at both the body function/structure and activity level domains of the International Classification of Functioning, Disability and Health. Investigation is now required to establish what amount and specific type of occupational therapy will further enhance functional outcomes and prolong the beneficial effects of BoNT-A. Methods/Design A randomised, controlled, evaluator blinded, prospective parallel-group trial. Eligible participants were children aged 18 months to 6 years, diagnosed with spastic hemiplegic cerebral palsy and who were able to demonstrate selective motor control of the affected upper limb. Both groups received upper limb injections of BoNT-A. Children were randomised to either the modified constraint-induced movement therapy group (experimental or bimanual occupational therapy group (control. Outcome assessments were undertaken at pre-injection and 1, 3 and 6 months following injection of BoNT-A. The primary outcome measure was the Assisting Hand Assessment. Secondary outcomes included: the Quality of Upper Extremity Skills Test; Pediatric Evaluation of Disability Inventory; Canadian Occupational Performance Measure; Goal Attainment Scaling; Pediatric Motor Activity Log; modified Ashworth Scale and; the modified Tardieu Scale. Discussion The aim of this paper is to describe the methodology of a randomised controlled trial comparing the effects of modified constraint-induced movement therapy (a uni-manual therapy versus bimanual occupational therapy (a bimanual therapy on improving bimanual upper limb performance of children with hemiplegic cerebral palsy following

  10. Pocketed microneedles for rapid delivery of a liquid-state botulinum toxin A formulation into human skin

    OpenAIRE

    Torrisi, B.M.; Zarnitsyn, V.; Prausnitz, M R; Anstey, A; Gateley, C.; Birchall, J.C.; Coulman, S.A

    2012-01-01

    Botulinum toxin A (BT) is used therapeutically for the treatment of primary focal hyperhidrosis, a chronic debilitating condition characterised by over-activity of the eccrine sweat glands. Systemic toxicity concerns require BT to be administered by local injection, which in the case of hyperhidrosis means multiple painful intradermal injections by a skilled clinician at 6-monthly intervals. This study investigates the potential of a liquid-loaded pocketed microneedle device to deliver botuli...

  11. The Efficacy of Botulinum Toxin Treatment for Children with a Persistent Esotropia Following Bilateral Medial Rectus Recessions and Lateral Rectus Resections

    Science.gov (United States)

    Lambert, Scott R.; Shainberg, Marla J.

    2015-01-01

    Background and Purpose To report on the outcomes of treating children with a persistent esotropia with an injection of botulinum toxin in a medial rectus muscle. Patients and Methods The medical records of all children at one institution with a persistent esotropia after bilateral medial rectus recessions and bilateral lateral rectus resections who were then treated with a botulinum toxin injection were reviewed. Results Five patients with a mean preoperative esotropia of 37 PD (range, 25-50 PD) underwent bilateral medial rectus recessions and then bilateral lateral rectus resections. Their residual esotropia (mean, 25 PD; range, 18-35) was then treated with a single injection of 3- 5 units of botulinum toxin into one medial rectus muscle. The patients were then followed for a mean of 34 months (range, 14 to 79 months). At last follow-up, 2 patients had an esotropia <10 PD. The other 3 patients had no long-term improvement in their ocular alignment. Two of these patients then underwent additional strabismus surgery. In both cases, they then developed a consecutive exotropia. Conclusion Treatment with a single injection of botulinum toxin was beneficial in 2 of 5 children. Botulinum toxin treatment alone did not result in a consecutive exotropia in any patients treated. PMID:24260804

  12. Anatomic considerations in botulinum toxin type A therapy for spasmodic dysphonia.

    Science.gov (United States)

    Castellanos, P F; Gates, G A; Esselman, G; Song, F; Vannier, M W; Kuo, M

    1994-06-01

    Chemodenervation by injection of botulinum toxin type A into the vocal fold(s) has become the preferred treatment for patients with adductor spasmodic dysphonia. Injection may be done either perorally or transcutaneously; each method has its advocates and advantages. The authors have used the transcutaneous transcricothyroid membrane route exclusively with satisfactory results in more than 50 patients. Temporary breathliness and aspiration are common. The preferred injection site should be as close as possible to the motor end plates of the affected muscle. The thyroarytenoid muscle end plates are distributed throughout the muscle, whereas in the lateral cricoarytenoid muscle they are located in band in the center of the muscle. The transcutaneous injection site is below and posterior to the midpoint of the vibrating vocal fold as visualized by indirect laryngoscopy. The proximity of this site to the lateral cricoarytenoid muscle suggests that postinjection breathiness and aspiration may be related to spread of botulinum toxin type A to the lateral cricoarytenoid muscle. However, it is likely that thyroarytenoid muscle paresis is mainly responsible for this side effect and that the rapid clearing of the breathy dysphonia in the face of prolonged relief of spasmodic dysphonia symptoms suggests the action of an adaptive neural response, such as axonal sprouting. Further research of this subject is warranted. PMID:8196438

  13. In Silico Analysis for the Study of Botulinum Toxin Structure

    Science.gov (United States)

    Suzuki, Tomonori; Miyazaki, Satoru

    2010-01-01

    Protein-protein interactions play many important roles in biological function. Knowledge of protein-protein complex structure is required for understanding the function. The determination of protein-protein complex structure by experimental studies remains difficult, therefore computational prediction of protein structures by structure modeling and docking studies is valuable method. In addition, MD simulation is also one of the most popular methods for protein structure modeling and characteristics. Here, we attempt to predict protein-protein complex structure and property using some of bioinformatic methods, and we focus botulinum toxin complex as target structure.

  14. Advances in Assays and Analytical Approaches for Botulinum Toxin Detection

    Energy Technology Data Exchange (ETDEWEB)

    Grate, Jay W.; Ozanich, Richard M.; Warner, Marvin G.; Bruckner-Lea, Cindy J.; Marks, James D.

    2010-08-04

    Methods to detect botulinum toxin, the most poisonous substance known, are reviewed. Current assays are being developed with two main objectives in mind: 1) to obtain sufficiently low detection limits to replace the mouse bioassay with an in vitro assay, and 2) to develop rapid assays for screening purposes that are as sensitive as possible while requiring an hour or less to process the sample an obtain the result. This review emphasizes the diverse analytical approaches and devices that have been developed over the last decade, while also briefly reviewing representative older immunoassays to provide background and context.

  15. Adductor laryngeal breathing dystonia in NBIA treated with botulinum toxin-A

    Directory of Open Access Journals (Sweden)

    Vinod Rai

    2013-01-01

    Full Text Available We report a rare case of neurodegeneration with brain iron accumulation (NBIA presented with episodic inspiratory stridor. A 10-year-old boy presented with 3-year history of gradually progressive spastic gait and generalized dystonia (involving all four limbs, neck, jaw, and speech. MRI brain showed "Eye of Tiger" sign. He recently developed severe inspiratory stridor associated with almost gasping respiration. Direct video laryngoscopy showed paradoxical vocal cord closure during inspiration. He was treated with EMG-guided botulinum toxin-A injection given into bilateral thyroarytenoid muscles, resulting in dramatic response with complete disappearance of the stridor within a week. The effect lasted 18 months.

  16. 多点微量皮内注射A型肉毒素治疗带状疱疹后遗神经痛的临床观察%Clinical Observation of Multiple Intradermal Small Bolus Injection of Botulinum Toxin A in Treatment of Postherpetic Neuralgia

    Institute of Scientific and Technical Information of China (English)

    程鹏; 何仁亮; 向红辉; 李凤春

    2014-01-01

    Objective:To observe the effect of multiple intradermal small bolus injection of botulinum toxin type A in the treatment of postherpetic neuralgia (PHN). Method:38 cases of PHN with multi point trace superficial injection were treated with botulinum toxin type A. Changhai pain rating scale standard visual analogue scale (VAS) score was used to observe the clinical effect. Result:There was significant effect in 28 cases,effective in 9 cases and invalid in 1 cases,and the total effective rate was 97.4%. Conclusion:Multiple intradermal small bolus injection of botulinum toxin type A may be effective in the treatment of PHN, with no complications caused by muscle relaxation.%目的:观察多点微量皮内注射A型肉毒毒素治疗带状疱疹后遗神经痛(PHN)的效果。方法:对38例PHN病人采用多点微量表浅注射A型肉毒素治疗,采用长海痛尺标准进行视觉模拟量表(VAS)评分,观察治疗效果。结果:显效28例,有效9例,无效1例,总有效率为97.4%。结论:多点微量皮内注射A型肉毒素可有效治疗PHN,无肌肉松驰导致的各种并发症。

  17. Adductor Spasmodic Dysphonia Treated by Injecting of Botulinum Toxin A into Vocal Cords%A型肉毒毒素声带注射 治疗内收型痉挛性发声障碍

    Institute of Scientific and Technical Information of China (English)

    刘波; 屈季宁; 李再香; 袁琨

    2001-01-01

    Objective To investigate the effect of botulinum toxin A(BTA) injected into vocal cords for the treatment of adductor spasmodic dysphonia (SD) by direct lanyngoscopy.Methods 11 patients with adductor SD were treated by injection on both vocal cords each with 2.5U of BTA by direct laryngoscopy.Results All patient's phonation improved within the first 24 hours,with sustained improvement from 12 to 21 weeks with an average of 16.2 weeks.The local side effect included breathy voice in all cases and mild choking sensation when drinking fluids in 5 cases,dysphagia in 3 cases.No systemic adverse reactions were noted.Conclusion The injection of BTA on both vocal cords by direct laryngoscopy is an effective,safe and simple method for the treatment of adductor SD.%目的探讨双侧声带注射A型肉毒毒素治疗内收性痉挛性发声障碍疗效。方法在直接喉镜下于双侧声带近外侧甲杓肌处注射A型肉毒毒素各2.5U治疗内收性痉挛性发声障碍11例。结果均在注射后24h即显效,发声改善平均持续时间16.2wk,不良反应有暂时过度呼吸音11例、饮水呛咳5例,吞咽困难3例,未发现A型肉毒毒素全身毒副作用。结论直接喉镜下A型肉毒毒素双侧声带注射是治疗内收性痉挛性发声障碍有效、安全、简便的方法。

  18. Characterisation of botulinum toxins type A and B, by matrix-assisted laser desorption ionisation and electrospray mass spectrometry

    NARCIS (Netherlands)

    Baar, B.L.M. van; Hulst, A.G.; Jong, A.L. de; Wils, E.R.J.

    2002-01-01

    A method earlier developed for the mass spectrometric (MS) identification of tetanus toxin (TTx) was applied to botulinum toxins type A and B (BTxA and BTxB). Botulinum toxins are extremely neurotoxic bacterial toxins, likely to be used as biological warfare agent. Biologically active BTxA and BTxB

  19. A New therapy of localized hyperhidrosis--injection of botulinum toxin A (a review)%局部多汗症治疗新方法--注射A型肉毒毒素

    Institute of Scientific and Technical Information of China (English)

    虞瑞尧

    2001-01-01

    @@ 多汗症(hyperhidrosis)是出汗过多,可限于局部,也可为全身性.虽然多汗症不是太重要的疾病,但它严重影响病人的生活质量和工作.多汗症还没有太好的治疗方法.近10年来采用A型肉毒毒素(botulinum toxin A)局部注射治疗取得了很好的疗效,为多汗症病人解除了痛苦,找到了一种有效的新方法.

  20. Clinical analysis of injecting A botulinum toxin in the treatment of upper lip twitching after gummy smile%A型肉毒毒素治疗露龈笑致上唇抽搐的临床体会

    Institute of Scientific and Technical Information of China (English)

    张芳; 王俊河; 朱彦凯

    2016-01-01

    Objective To introduce 2 cases using type-A botulinum toxin to cure upper lip twitching after gummy smile and brielfy analyse the reasons that may appear.MethodsThe author reviewed the medical history,treatment and postoperative conditions of two patients using type- A botulinum toxin to treat upper lip twitching after gummy smile and being operated from 2014 to 2015.Then we discussed the causes. ResultsThe muscle spasm caused by type-A botulinum toxin was occasional complications,which may be related to the injury of local acupuncture. Conclusion Botulinum toxin has a good effect with small trauma,and occasionally adverse reactions in the treatment of muscle spasm and gummy smile.It requires physicians be familiar with anatomy, avoid injury and notice follow-ups.%目的:介绍A型肉毒毒素注射治疗露龈笑后出现上唇抽搐的病例,并对其出现原因进行简要分析。方法:笔者对2014年-2015年治疗的2例A型肉毒毒素注射治疗露龈笑后出现上唇抽搐患者的病史、治疗经过及术后并发症进行回顾分析,探讨原因。结果:A型肉毒毒素致肌肉抽搐为偶见并发症,可能与局部针刺损伤有关。结论:肉毒毒素治疗肌肉痉挛及露龈笑效果好、创伤小,偶有不良反应,特别是作为美容用途时,要求医师熟悉解剖、避免损伤、注意随访。

  1. Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial.

    Science.gov (United States)

    Visco, Anthony G; Brubaker, Linda; Richter, Holly E; Nygaard, Ingrid; Paraiso, Marie Fidela; Menefee, Shawn A; Schaffer, Joseph; Wei, John; Chai, Toby; Janz, Nancy; Spino, Cathie; Meikle, Susan

    2012-01-01

    This trial compares the change in urgency urinary incontinence episodes over 6 months, tolerability and cost effectiveness between women receiving daily anticholinergic therapy plus a single intra-detrusor injection of saline versus a single intra-detrusor injection of 100 U of botulinum toxin A plus daily oral placebo tablets. We present the rationale and design of a randomized-controlled trial, Anticholinergic versus Botulinum Toxin, Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC trial, conducted by the NICHD-funded Pelvic Floor Disorders Network. We discuss the innovative nature of this trial and the challenges related to choice of patient population, maintaining masking, cost effectiveness, ethical considerations, measuring adherence, and placebo development and testing. Enrollment began in April, 2010. 242 participants will be randomized and primary outcome data analysis is anticipated to begin in mid 2012. Several challenges in the trial design are discussed. Randomization to placebo intra-detrusor injections may limit recruitment, potentially impacting generalizability. Other challenges included the heavy marketing of drugs for overactive bladder which could impact recruitment of drug-naïve women. In addition, anticholinergic medications often cause dry mouth, making masking difficult. Finally, adverse reporting of transient urinary retention is challenging as there is no standardized definition; yet this is the most common adverse event following intra-detrusor botulinum toxin injection. The ABC trial will help women with urgency urinary incontinence balance efficacy, side effects and cost of anticholinergic medication versus botulinum toxin intra-detrusor injection. The results have the potential to fundamentally change the therapeutic approach to this condition. PMID:22008247

  2. Effect of different-dose botulinum toxin A intradermal injection on axillary hyperhidrosis%不同剂量A型肉毒毒素皮内注射治疗腋部多汗症效果观察

    Institute of Scientific and Technical Information of China (English)

    高扬; 杨亚东; 王元元; 杨洋; 鲁元刚

    2013-01-01

    目的 评估不同剂量A型肉毒毒素治疗腋部多汗症的时效.方法 腋部多汗症患者86例,患者左右侧腋窝自身对照:左侧为小剂量A型肉毒毒素注射组,皮内注射生理盐水稀释的A型肉毒毒素50U;右侧为大剂量A型肉毒毒素注射组,皮内注射生理盐水稀释的A型肉毒毒素200U;随访3~29个月,观察两组并发症,并建立两组等级资料,行x2检验,评价患者两侧腋窝维持疗效的时间差异.结果 两组疗效进行对比,大剂量与小剂量的A型肉毒毒素的疗效维持时间的差异有统计学意义(P<0.05).结论 大剂量A型肉毒毒素能够显著延长腋部多汗症疗效时间.%Objective To evaluate the long-term effectiveness of different-dose of botulinum toxin A (BTXA) therapy on axillary hyperhidrosis.Methods Total 86 patients with axillary hyperhidrosis were self-controlled.One group of left axillary was injected with a low-dose of BTXA,50U.Another group of right axillary was injected with a high-dose of BTXA.A total dose of 200 U of BTXA was used per axilla.Patients were followed-up for 29 months.To investigate the effect of two methods,we analyzed two ranked data by rank sum test and x2 test to judge the disparities of the therapeutic effect.Results The results showed that the relapse-free interval of two groups with axillary hyperhidrosis was significant difference through the statistical analysis (P < 0.05).Conclusions High-dose of BTXA treatment is capable of prolonging the antihidrotic effect on axillary hyperhidrosis.

  3. THE PROPERTIES AND LONGITUDINAL EXPERIENCE OF CHINESE TYPE A BOTULINUM TOXIN FOR THE TREATMENT OF FOCAL DYSTONIA AND HEMIFACIAL SPASM

    Institute of Scientific and Technical Information of China (English)

    万新华; 汤晓芙; 王荫椿

    2003-01-01

    Objective. To introduce the properties of Chinese type A botulinum toxin (CBTXA, made by Lanzhou Institute of Biological Products), and its long-term effect for focal dystonia and hemifacial spasm. Method. The purity and recovery of crude and crystalline toxin were tested. Long-term data from 305 patients with hemifacial spasm (HFS), blepharospasm (BS) and cervical dystonia (CD) were evaluated and subgroups of patients received CBTXA injections between 1994 and 2000 in at least six separate treatment sessions, with follow up for 2-8 years. The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session. Result. CBTXA purity was high[(2.55~2.60)×107D50/mgPr, A260/A280 ≤0.55, high molecular substance accounted for 99.2% of total proteins]. Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit, and efficacy may improve slightly with repeat treatments. CBTXA is an excellent long-term treatment of HFS, BS and CD. Conchusion. We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long-term clinical applications. The reinjection of CBTXA significantly improves the quality of life of most patients and is a safe, effective and comparatively economical treatment for patients with focal dystonia and HFS.

  4. Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children

    OpenAIRE

    Zeino, Mazen; Becker, Tanja; Koen, Mark; Berger, Christoph; Riccabona, Marcus

    2012-01-01

    Purpose To prove the long-term efficacy of BTX-A injection in the management of children with neurogenic detrusor hyperactivity. Materials and methods 28 out of 145 children with neurogenic bladder (15 male and 13 female, mean age 10.7 years) who were treated between 2002 and 2010 and became non-responders to conservative treatment were included into the retrospective study. We injected 10-12 U/kg of BTX-A (Botox®) into the detrusor at 20-30 sites, sparing the trigone. The mean follow-up was ...

  5. Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Marc Axel Wollmer

    2014-03-01

    Full Text Available In a randomized, controlled trial (n=30 we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9 of the Hamilton Depression Rating Scale (HAM-D between responders (n=9 and participants who did not attain response (n=6 among the recipients of onabotulinumtoxinA (n=15. Results: Responders had significantly higher item 9 scores at baseline (1.56+0.88 vs. 0.33+0.52, t(13=3.04, d=1.7, p=0.01, while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC analysis (area under the curve, AUC=0.87. These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment.

  6. Successful treatment of tardive lingual dystonia with botulinum toxin: case report and review of the literature.

    Science.gov (United States)

    Hennings, Johannes M H; Krause, Eike; Bötzel, Kai; Wetter, Thomas C

    2008-07-01

    Tardive dyskinesia (TD) is a dreaded side effect of antipsychotic medication. Recommended treatments for TD may provide reliable improvement but can be, in turn, associated with additional adverse reactions. Recently, several reports have suggested that botulinum toxin A (BTX-A) injection in affected muscles may significantly improve TD. Here, we report a case of severe tongue protrusion dystonia secondary to an antipsychotic medication in a young man. Several approaches including clozapine, amisulpride, aripiprazole, ziprasidone, tiapride and clonazepam failed to improve the symptoms. Injection of 50 U of BTX-A (Dysport, Ipsen, Ettlingen, Germany) into each genioglossal muscle dramatically improved tongue protrusion within few days with a sustained effect. If reasonable precautions are taken, the application seems to be well tolerated with only minor side effects. A review of the literature that is part of this article adverts BTX-A injection as a potential beneficial approach of various kinds of TD. PMID:17936461

  7. A monoclonal antibody based capture ELISA for botulinum neurotoxin serotype B: toxin detection in food

    Science.gov (United States)

    Botulism is a serious foodborne neuroparalyic disease caused by botulinum neurotoxin (BoNT) produced by the anaerobic bacterium Clostridium botulinum. Seven toxin serotypes (A-H) have been described. The majority of human cases of botulism are caused by serotypes A and B followed by E and F. We repo...

  8. [Botulinum toxin type A in headache treatment : Established and experimental indications].

    Science.gov (United States)

    Gaul, C; Holle-Lee, D; Straube, A

    2016-08-01

    In recent years botulinum toxin type A has been used increasingly more in the treatment of specific headache disorders. Especially regarding chronic migraine with and without combined medication overuse, convincing randomized studies have proven the efficacy of this treatment option and have led to approval for this indication. Regarding other headache entities, such as episodic migraine, tension-type headache, trigeminal autonomic cephalalgia (TAC), neuralgic, neuropathic and myofascial pain, currently available scientific data on the efficacy of botulinum toxin type A are scarce and often ambiguous. The exact underlying mechanisms of the influence of botulinum toxin type A on the pathophysiology of headache are not completely clear but an influence on the release of calcitonin gene-related peptide (CGRP) seems to play a crucial role. This article summarizes the most important studies as well as experiences of treatment with botulinum toxin type A regarding different headache entities. PMID:27300190

  9. Treatment of axillary hyperhidrosis and bromidrosis with botulinum toxin (BTX)-A injection%A型肉毒毒素注射治疗腋窝多汗症或伴腋臭症

    Institute of Scientific and Technical Information of China (English)

    王琳; 高赫; 魏丽岩; 孔雀

    2009-01-01

    Objective To probe the advantages of BTX-A for the treatment of axillary hyper-hidrosis. Methods 42 cases were treated by BTX-A injection, 50 units per axillae, 25 sites with 2 u-nits each, 1.5 cm apart. They consisted of 24 cases of axillary hyperhidrosis, 10 cases of axillary hy-perhidrosis combined bromidrosis, and 8 cases of bromidrosis. Results All hyperhidrosis patients a-chieved good effects. Among patients with axillary hyperhidrosis combined bromidrosis, it had effects on hyperhidrosis, but only one case effected on bromidrosis. Among patients with bromidrosis, only one case had effect. Conclusions In the treatment of hyperhidrosis, BTX-A is very useful, and side effect is temporary and slight. But for bromidrosis, BTX-A is not very useful.%目的 探讨A型肉毒毒素(botulinum toxin-A,BTX-A)注射治疗腋窝多汗症或伴腋臭症及单纯液臭的疗效.方法 采用BTX-A每侧腋窝注射50 U治疗,注射选点25个,间距1.5 cm,每点注射2.5 U.结果 共治疗特发性局限性腋窝多汗症或伴腋臭患者42例,其中单纯腋窝多汗症24例全部有效.腋窝多汗症伴有腋臭10例,其中注射后多汗症治疗全部有效,腋臭治疗有效者只有1例.单纯腋臭8例,碘淀粉试验阴性,注射后只有1例显效,无效7例.结论 BTX-A治疗腋窝多汗症有效,副作用轻微、一过性.BTX-A治疗多汗症所伴有的腋臭疗效欠佳,对单纯的腋臭治疗基本无效.

  10. Botulinum toxin type A in the treatment of patients with cervical dystonia

    OpenAIRE

    Allison Brashear

    2008-01-01

    Allison BrashearDept of Neurology, Wake Forest University Baptist, Medical Center, Winston Salem, NC, USAAbstract: Dystonia is an involuntary movement involving twisting and turning of agonist and antagonist muscles. Cervical dystonia is isolated to neck musculature. Botulinum toxin type A is a safe and effective treatment of this disabling and often painful syndrome. Three forms of botulinum toxin type A are available worldwide to treat patients with cervical dystonia. This is a review of th...

  11. Applications of botulinum toxin in dentistry: A comprehensive review.

    Science.gov (United States)

    Srivastava, Sanjeev; Kharbanda, Smriti; Pal, U S; Shah, Vinit

    2015-01-01

    The horizons of treatment options in dentistry are broadening rapidly. In this scenario, applications of unconventional treatment options like use of botulinum toxin (BT) are gaining momentum. The use of BT has been popularly accepted in esthetic procedures like management of facial wrinkles; however, it has been documented to be successful in a variety of conditions. Of particular interest to this paper are applications of BT in the maxillofacial region, concerned to dentistry. BT offers a transient, reversible, relatively safe treatment option to many conditions of interest to a dental practitioner. Dental surgeons by their virtue of being extensively aware of the anatomy of faciomaxillary region are a potential pool of operators who can use BT in their armamentarium with minor skill enhancement and thus widen the perspective of alternative, minimally invasive options to refractory conditions or invasive protocols. PMID:27390488

  12. Antagonism of the paralysis produced by botulinum toxin in the rat. The effects of tetraethylammonium, guanidine and 4-aminopyridine.

    Science.gov (United States)

    Lundh, H; Leander, S; Thesleff, S

    1977-05-01

    The injection of botulinum toxin type A into the hind-leg of adult rats causes complete paralysis of the leg lasting for several weeks. In the extensor digitorum longus (EDL) muscle transmitter release is reduced to a level of less than 1% of normal. Tetraethylammonium (TEA) and guanidine in concentrations of about 3 mM restore, in EDL muslces in vitro, neuromuscular transmission to about the normal level, provided that the external calcium concentration is 4 mM or higher. 4-Aminopyridine (4-AP) has similar restorative effect but is about 20-30 times more potent. Unlike TEA and guanidine, 4-AP is effective when the ambient calcium concentration is 2 mM; this drug is therefore also active in vivo. The intravenous injection of 4-AP (5 mg/kg body weight) restores neuromuscular transmission from complete paralysis by botulinum toxin to a normal level as shown by the recording of almost normal twitch and tetanic tensions in the EDL muscle. In rats paralysed by a lethal dose of botulinum toxin, the intraperitoneal administration of 4-AP restores general motor activity, the effect lasting 1-2 hours. A study of the effects of these drugs on spontaneous and evoked transmitter release suggests that all three compounds increase the level of free calcium inside the nerve terminals. In botulinum poisoning the transmitter release mechanism appears to be intact, but a reduced sensitivity to calcium has been shown (Cull-Candy et al. 1976), and this could explain why the drugs restore evoked transmitter release in botulinum poisoning. PMID:194021

  13. 肉毒毒素注射与射频温控热凝术治疗原发性半侧面肌痉挛的疗效比较%Comparison of clinical effects between botulinum toxin injection and radiofrequency thermal rhizotomy in treatment of primary hemifacial spasm

    Institute of Scientific and Technical Information of China (English)

    李焰; 张建设; 郑维银; 王晋; 李晨军

    2012-01-01

    目的 对比肉毒毒素注射与射频温控热凝术治疗原发性单侧面肌痉挛的临床疗效,以寻求最佳的治疗方法.方法 118例患者分别采用面部肌肉肉毒毒素-A注射法与面神经总干射频温控热凝术治疗.治疗后随访,对两种治疗方式的疗效、并发症和复发率进行统计对比.结果 肉毒毒素-A注射疗法的近期疗效(1个月)优于射频温控热凝疗法,远期(6个月)疗效下降,复发率72.5%,但引发面瘫并发症的概率极低;射频温控热凝术治疗的远期疗效优于肉毒毒素-A注射,6个月后复发率仅为21.4%,但有出现治疗后面瘫并发症之虞.结论 肉毒毒素-A注射和射频温控热凝术相比较“各有千秋”,治疗后在短期内两者均具有较高的有效性,前者的副作用更小,但复发率高,临床治疗中应当量情分别选用.%Objective To compare the clinical effects of botulinum toxin injection and radiofre quency thermal rhizotom in the treatment of primary hemifacial spasm.Methods A total 118 primary hemifacial spasm patients were randomly divided into two groups,who were received botulinum toxinA injections and radiofrequency thermal rhizotom treatment,respectively.Patients were followed up,and the curative effect,complications and recurrence rates of the two treatments were statistically compared.Results The early curative effect (1 month) for primary hemifacial spasm in botulinum toxin injection group was better than that in radiofrequency thermal rhizotom treatment group:recurrence rate of long-term (6 months) was 72.5 %,but caused a very low risk of facial paralysis; radiofrequency thermal rhizotom treatment had a long-term effect as compared with botulinum toxin injection,6 months recurrence rate was 21.4 %,with a low rate of postoperative facial paralysis.Conclusions Botulinum toxin injections is higher in short-term effectiveness and smaller in side effects as compared with the treatment of radiofrequency thermal

  14. The use of botulinum toxin as primary or adjunctive treatment for post acne and traumatic scarring

    Directory of Open Access Journals (Sweden)

    Greg J Goodman

    2010-01-01

    Full Text Available Background : Botulinum toxin has been utilised successfully in many facial and extra facial regions to limit superfluous movement. Scars, whether traumatic or disease-related, are treated with many modalities. Objective: To assess the available literature concerning the prophylactic use of botulinum toxin for the improvement in the cosmetic outcome of scars induced by surgery and to examine its role in the treatment of established scars alone, as also combined with other modalities. Material and Methods : The results of the prophylactic use of botulinum toxin to limit the resultant scarring from surgery are examined by a literature review. The primary and adjunctive use of botulinum toxin in the treatment of post acne and post surgical and traumatic scars is explored by case examples. Results : Literature review and personal experience shows good Improvement in the appearance of scars with the use of botulinum toxin alone or with other adjuvant modalities in the treatment of scars. Conclusion : Botulinum toxin would appear to be useful both in the prophylaxis and treatment of certain types of scars.

  15. 注射用A型肉毒毒素的生物学特性及质量分析%Biological characteristics and quality of botulinum toxin type A for injection

    Institute of Scientific and Technical Information of China (English)

    何星; 苗承辉; 李小娟; 王云天; 梁琪; 张雪平; 王荫椿

    2012-01-01

    Objective To analyze the property of active pharmaceutical ingredient (API) of botulinum toxin type A (BTXA) for injection, as well as the specific activities of the preparations manufactured in 2009~2011. Methods Various components were separated from the harvested BTXA by anion exchange chromatography. The properties of BTXA complex and its components were analyzed by hemagglutination test, HPLC, SDS-PAGE, isoelectric focusing eleetrophoresis and amino acid sequencing at N-terminus. The data on specific activity of bulks of BTXA manufactured in 2009~2011 were analyzed, based on which the stability of production procedure and the reproducibility of quality were evaluated. Results The harvested BTXA was dissociated in basic environment. The obtained neurotoxin showed no hemagglutination titer, of which the relative molecular mass was about 150 000. The API of BTXA was an intact monomer, of which the purity was more than 99. 5%. The isoelectric points of BTXA complex and neurotoxin were 4. 97 and 4. 91 respectively, of which the amino acid sequences at N-terminus were basically consistent with those reported in GenBank. The mean specific activity of bulks of BTXA manufactured in 2009~2011 was 3. 0×107 LD50/mg protein. The load of API in final product of BTXA was about 5 ng per container. Conclusion The API of BTXA was a specific complex which was dissociated in basic environment to obtain neurotoxin. The specific activities of bulk BTXA manufactured in 2009~2011 were stable, indicating good persistency of quality, which provided a basis for safety of BTXA in clinic.%目的 对注射用A型肉毒毒素(Botulinum toxin type A for injection,商品名衡力,出口商品名BTXA)制品中的活性药用成分(Active pharmaceutical ingredient,API)的性质及2009 ~ 2011年生产的注射用A型肉毒毒素原液的比活性进行分析.方法 对BTXA收获物样品进行阴离子交换层析,分离毒素复合体各组分;采用血凝试验、HPLC法、SDS

  16. Eficácia do resfriamento da pele no alívio da dor desencadeada pela injeção de toxina botulínica tipo A nas distonias faciais Skin cooling efficacy on pain relief in periocular injections with botulinum toxin A in facial dystonias

    Directory of Open Access Journals (Sweden)

    Paula Barros Bandeira de Mello Monteiro

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a eficácia do resfriamento da pele com gelo no alívio da dor desencadeada pela injeção de toxina botulínica tipo A na região periocular em pacientes portadores de distonia facial. MÉTODOS: Neste estudo prospectivo, 13 pacientes receberam injeção de toxina botulínica tipo A em região glabelar (m. prócero e periocular (m. orbicular para tratamento de distonia facial. Antes das aplicações, um lado da região glabelar foi resfriado com gelo durante 5 minutos, enquanto no outro lado foi aplicada pomada Epitezan®, funcionando como placebo. A aplicação foi feita primeiramente no lado resfriado. Após a aplicação em cada um dos lados os pacientes foram instruídos a dar uma nota para a dor desencadeada pela injeção, em uma escala de 0 a 10 onde 0 era ausência de dor e 10 a dor mais intensa. RESULTADOS: A média das notas dadas pelos pacientes à dor desencadeada pela injeção no lado onde foi aplicado placebo foi 3,92 ± 3,28. No local onde foi aplicado gelo a média das notas foi de 2,92 ± 2,18 (p PURPOSE: To evaluate the efficacy of skin cooling with ice on pain relief in periocular injection with botulinum toxin type A in patients with facial dystonias. METHODS: In this prospective study, 13 patients received botulinum toxin type A injection in glabela (procerus m. and periocular region (orbicular m. for facial dystonias treatment. Before the injections, one side of the glabela was submitted to a 5-minute cooling period, while the opposite side had Epitezan® cream applied, as a placebo. The application was done at the cooled side first. After the application on each side the patients were instructed to rate the pain associated with the injection on a scale from 0 to 10, with 0 indicating no pain and 10 the worst pain. RESULTS: The average pain score on the side where cold was applied was 3,92 ± 3,28, while on the control side the average pain score was 2,92 ± 2,18 (p < 0,0166. CONCLUSION: In this study

  17. Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

    Science.gov (United States)

    Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

    2006-01-01

    Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

  18. Botulinum toxin-a in children with congenital spastic hemiplegia does not improve upper extremity motor-related function over rehabilitation alone: a randomized controlled trial.

    NARCIS (Netherlands)

    Rameckers, E.A.A.; Speth, L.A.; Duysens, J.E.J.; Vles, J.S.; Smits-Engelsman, B.C.M.

    2009-01-01

    BACKGROUND: Rehabilitation of the upper extremity in children with hemiplegic cerebral palsy has not been compared to the same intensity of therapy combined with injected botulinum toxin (BTX). OBJECTIVE: To measure the short-term (2 weeks) and long-term (6 and 9 months) effects of a standardized fu

  19. Clinical studies of small amount of botulinum toxin type a local injection in patients with upper facial wrinkles%局部注射少量A型肉毒毒素治疗上半面部皱纹的临床研究

    Institute of Scientific and Technical Information of China (English)

    尚晓旭; 吴景东

    2011-01-01

    目的:观察局部注射少量A型肉毒毒素(BTXA)去除上半面部皱纹的临床疗效.方法:应用A型肉毒毒素的198例患者,其中眉间纹65例,鱼尾纹80例,额纹20例,鼻背部皱纹33例.所有患者行局部多点注射A型肉毒毒素,浓度为4U/0.1ml,并根据不同的患者调整剂量和浓度.记录患者疗效、维持时间与不良反应.结果:A型肉毒毒素治疗面部上三分之一皱纹有效率为100%,显效率94.4%.肌肉麻痹的效果通常持续3~6个月不等,不良反应主要为4例上睑下垂,3例局部水肿和4例青紫,各占2.0%、1.5%和2.0%.上述症状于3~10内自行完全消失.结论:A型肉毒毒素局部注射治疗面部上三分之一皱纹起效迅速、无创伤、简便易行.%Objective To observe the clinical effect of small amount of botulinum toxin type A (BTXA) local injection to remove half of the clinical effect of facial wrinkles. Methods 198 botulinum toxin type A patients, including 65 cases of frown lines, 80 cases of crow's feet, 20 cases of the wrinkles on the forehead, 33 cases of wrinkles of nasal back. All patients underwent local multi-point injection of botulinum toxin type A, the concentration is 4U/0.1ml, and adjusted the dose according to different patient and concentration. We recorded the outcomes, effective duration and adverse reactions. Results The effective rate of botulinum toxin type A in treatment with facial wrinkles was 100%, the obvious rate was 94.4%,and the effective duration lasts 3-6 months. The adverse effects of treatment were four cases of ptosis, 3 and 4 cases with local edema and bruising,taking account 2.0%, 1.5% and 2.0%, respectively. The symptoms disappeared on their own way. Conclusion A local injection of botulinum toxin type A treatment of upper a third facial wrinkles was rapid onset, non-invasive, non-traumatic and simple.

  20. 外周神经电刺激引导下A型肉毒毒素注射在痉挛型脑性瘫痪中的应用%Injection of Botulinum Toxin Type A Guided by Peripheral Nerve Stimulation for Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    邵银进; 吴桂华; 曾康华

    2013-01-01

    Objective To investigate the effects of local injection of Botulinum toxin type A (BTX-A) on spastic cerebral palsy guided by peripheral nerve stimulation. Methods 30 children with spastic cerebral palsy received local multi-point injection of BTX-A guided by peripheral nerve stimulation. They were assessed with modified Ashworth scale (MAS) and Gross Motor Function Assessment Scale (GM-FM-88) before and 1 week, 3 months and 6 months after treatment. Results The scores of MAS decreased significantly 1 week, 3 months and 6 months after treatment (P0.05),3个月和6个月时显著增加(P<0.001)。结论外周神经电刺激引导下BTX-A局部多点注射治疗痉挛型脑瘫疗效显著。

  1. Clinical use of non-A botulinum toxins: botulinum toxin type B.

    Science.gov (United States)

    Dressler, D; Eleopra, R

    2006-04-01

    Botulinum neurotoxin type B (BT, BT-B) has been used as NeuroBloc/MyoBloc since 1999 for treatment of cervical dystonia, hyperhidrosis, spastic conditions, cerebral palsy, hemifacial spasm, bladder dysfunction, spasmodic dysphonia, sialorrhoea, anal fissures, piriformis syndrome, various pain conditions and cosmetic applications. Generally, its therapeutic effects are comparable to BT type A (BT-A). The adverse effect profiles of BT-B and BT-A, however, differ considerably. BT-B has been found to produce more regional as well as systemic anticholinergic adverse effects, such as dryness of mouth, accommodation difficulties, conjunctival irritation, reduced sweating, dysphagia, heartburn, constipation, bladder voiding difficulties and dryness of nasal mucosa. In BT-B the relationship between autonomic and motor effects known from BT-A is substantially shifted towards autonomic effects. BT-B, therefore, should be used carefully in patients with autonomic disorders and in patients with concomitant anticholinergic therapy. If NeuroBloc/MyoBloc is used to treat cervical dystonia patients with antibody-induced failure of BT-A therapy, 86% of those will develop complete secondary therapy failure after five applications. If NeuroBloc/MyoBloc used to treat cervical dystonia patients without prior exposure to BT, 44% of those will develop complete secondary therapy failure after nine applications. NeuroBloc/MyoBloc, therefore, is associated with substantial antigenicity problems originating from a particular low specific biological potency. Systemic anticholinergic adverse effects and high antigenicity limits the clinical use of NeuroBloc/MyoBloc considerably. PMID:16785108

  2. Botulinum toxin in the treatment of orofacial tardive dyskinesia : A single blind study

    NARCIS (Netherlands)

    Slotema, Christina W.; van Harten, Peter N.; Bruggeman, Richard; Hoek, Hans W.

    2008-01-01

    Objective: Orofacial tardive dyskinesia (OTD) is difficult to treat and Botulinium Toxin A (BTA) may be an option. Methods: In a single blind (raters were blind) study (N= 12, duration 33 weeks) OTD was treated with Botulinum Toxin A in three consecutive sessions with increasing dosages. The severit

  3. Botulinum toxin to improve results in cleft lip repair: a double-blinded, randomized, vehicle-controlled clinical trial.

    Directory of Open Access Journals (Sweden)

    Chun-Shin Chang

    Full Text Available BACKGROUND: Most patients with facial scarring would value even a slight improvement in scar quality. Botulinum toxin A is widely used to alleviate facial dynamic rhytides but is also believed to improve scar quality by reducing wound tension during healing. The main objective was to assess the effect of Botulinum toxin on scars resultant from standardized upper lip wounds. METHODS: In this double-blinded, randomized, vehicle-controlled, prospective clinical trial, 60 consecutive consenting adults undergoing cleft lip scar revision (CLSR surgery between July 2010 and March 2012 were randomized to receive botulinum toxin A (n = 30 or vehicle (normal saline; n = 30 injections into the subjacent orbicularis oris muscle immediately after wound closure. Scars were independently assessed at 6-months follow-up in blinded fashion using: Vancouver Scar Scale (VSS, Visual Analogue Scale (VAS and photographic plus ultrasound measurements of scar widths. RESULTS: 58 patients completed the trial. All scar assessment modalities revealed statistically significantly better scars in the experimental than the vehicle-control group. CONCLUSION: Quality of surgical upper lip scars, which are oriented perpendicular to the direction of pull of the underlying orbicularis oris muscle, is significantly improved by its temporary paralysis during wound healing. TRIAL REGISTRATION: ClinicalTrials.gov NCT01429402.

  4. Botulinum toxin for treating muscular temporomandibular disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Eduardo Machado

    2012-12-01

    Full Text Available OBJECTIVE: This study, through a systematic literature review, aims to analyze the effectiveness of Botulinum Toxin as a treatment for masticatory myofascial pain and muscles temporomandibular disorders (TMD. METHODS: Survey in research bases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and April 2011, with focus in randomized or quasi-randomized controlled clinical trials, blind or double-blind. RESULTS: After applying the inclusion criteria, 4 articles comprised the final sample: 3 were double-blind randomized controlled clinical trials and 1 was single-blind randomized controlled clinical trial. CONCLUSIONS: According to the literature, there is lack of evidence about the real effectiveness of botulinum toxin in the treatment of masticatory myofascial pain and muscular TMD. Thus, further randomized controlled clinical trials, with representative samples and longer follow-up time, to assess the real effectiveness of the technique are needed.OBJETIVO: este trabalho, por meio de uma revisão sistemática da literatura, teve como objetivo analisar a efetividade da toxina botulínica como tratamento para dor miofascial mastigatória e disfunções temporomandibulares (DTM musculares. MÉTODOS: pesquisa nas bases de dados Medline, Cochrane, Embase, Pubmed, Lilacs e BBO, no período entre 1966 e abril de 2011, com enfoque em estudos clínicos controlados randomizados ou quase-randomizados, cegos ou duplo-cegos. RESULTADOS: após a aplicação dos critérios de inclusão, chegou-se a 4 artigos, sendo que 3 eram estudos clínicos controlados randomizados duplo-cego e 1 era estudo clínico controlado randomizado simples-cego. CONCLUSÕES: pela análise da literatura, verificou-se um número reduzido de evidências significativas sobre a real efetividade da toxina botulínica no tratamento da dor miofascial e de DTM musculares. Assim, são necessários novos estudos clínicos controlados randomizados, com amostras

  5. A型肉毒毒素联合Lux1540-非剥脱点阵激光治疗额部皱纹的临床疗效和安全性观察%CLINICAL EFFECT AND SAFETY OBSERBATION OF BOTULINUM TOXIN TYPE A INJECTION COMBINED WITH LUX 1540 FRACTIONAL LASER ON WRINKLES

    Institute of Scientific and Technical Information of China (English)

    苏雪莲

    2015-01-01

    Objective To evaluate the effectiveness and safety of botulinum toxin type A injection andLux1540fractional laser on treatment of eye wrinkles.Methods Sixty patients with wrinkles,aged from 27 to65,were divided into three groups randomly.They were treated with botulinum toxin type A,Lux1540 fractional laser,or the combined therapy.Pictures were taken for each patient before treatment and immediate,at 7 daysand 1,3,6months after treatment,with which the results were evaluated.ResultsAt 3 to 7days after treatment,the dynamic wrinkles of patients treated with botnlinum toxin type A injection were alleviated. The static wrinkles of patients treated with Lux1540 fractional laser with or without botulinum toxin type A injection were alleviated right after the treatment.The dynamic wrinkles of those who treated with the combined therapy got better long—term effect.Conclusion It is effective and safe to treat eye wrinkles by using botulinum toxin type A injection and Lux1540 fractional laser combined therapy.%目的:探讨A型肉毒毒素联合Lux1540-非剥脱点阵激光:点阵激光治疗额头皱纹的临床疗效和安全性。方法将年龄27~65岁且寻求改善额头皱纹的门诊患者60例,随机平均分为3组,分别给予A型肉毒毒素注射,Lux1540-非剥脱点阵激光治疗,A型肉毒毒素注射联合Lux1540-非剥脱点阵激光治疗。每例患者在治疗前,治疗后即刻,治疗后7 d、1、3、6个月进行随访评价。结果单纯接受肉毒毒素注射的患者,在治疗后3~7 d开始出现动态皱纹的改善;接受Lux1540-非剥脱点阵激光以及A型肉毒毒素注射联合Lux1540-非剥脱点阵激光治疗的患者,术后即刻可观察到静态皱纹的改善,且肉毒毒素注射联合Lux1540-非剥脱点阵激光的患者,其动态皱纹的远期效果改善更加明显。结论 A型肉毒毒素联合Lux1540-非剥脱点阵激光,治疗可同时改善额部的动态皱纹和静态皱纹,并有

  6. [Treated patients in survey: High satisfaction with botulinum toxin in palmar hyperhidrosis].

    Science.gov (United States)

    Deebaj, Richard; Emtestam, Lennart; Lundeberg, Lena; Brandin Samuelsson, Karin; Girnita, Ada

    2015-01-01

    When debilitating, hyperhidrosis can be seen as a disease and not just as a symptom. It is most often a primary condition but can be secondary to other diseases. Aluminum chloride products are the initial treatment modality for palmar hyperhidrosis followed by anticholinergics, iontophoresis and botulinum toxin. The Dermatology Department of the Karolinska University Hospital in Stockholm, Sweden treated 151 patients at 289 visits with botulinum toxin for palmar hyperhidrosis during a two year period (2012-2013). It was found that botulinum toxin had good effect, which lasted between two and five months in 72% of cases. Muscle weakness (pincer grip) was reported at 41% of return visits and was present for less than one to four weeks in 62% of cases. At 56% of return visits, no side effects of botulinum toxin were reported. 90% of patients surveyed thought that botulinum toxin worked well or very well for their condition and 99% valued the treatment they received at the clinic as good to excellent. PMID:25625725

  7. Botulinum toxin A for treatment of neurogenic detrusor overactivity and incontinence in patients with spinal cord lesions

    DEFF Research Database (Denmark)

    Bagi, Per; Biering-Sørensen, Fin

    2004-01-01

    To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs).......To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs)....

  8. Use of botulinum toxin-A for musculoskeletal pain in patients with whiplash associated disorders [ISRCTN68653575

    Directory of Open Access Journals (Sweden)

    Juan Francisco J

    2004-02-01

    Full Text Available Abstract Background Whiplash associated disorder is commonly linked to motor vehicle accidents and sports injuries. Cervical injury is attributed to rapid extension followed by neck flexion. The exact pathophysiology of whiplash is uncertain but probably involves some degree of aberrant muscle spasms and may produce a wide range of symptoms. The most commonly prescribed pharmacological agents for initial treatment of whiplash-associated pain are oral muscle relaxants and nonsteroidal anti-inflammatory drugs. However, potential systemic adverse effects limit these agents. Physical interventions such as mobilization, manipulation, and exercises have proved beneficial for pain and dysfunction but only on a time-limited basis. Little evidence suggests that physical therapy specifically aimed at the musculature (e.g., transcutaneous electrical nerve stimulation, ultrasonography, heat, ice, and acupuncture improves prognosis in acute whiplash associated disorder. A new approach to treatment is the use of botulinum toxin, which acts to reduce muscle spasms. Methods/design This is a prospective, randomized, controlled clinical trial and botulinum toxin-A (Botox® injections will be compared with placebo injections. The primary objective is to determine the efficacy of Botox® in the management of musculoskeletal pain in whiplash associated disorders. Discussion Botulinum toxin type-A toxin has been studied in small trials on whiplash associated disorder patients and has generally been found to relieve pain and improve range of motion. Specifically, we seek to assess the efficacy of Botox® in reducing pain and to improve the cervical spine range of movement, during the 6-month trial period.

  9. The change of substance P in neuropathic pain rats injected subcutaneous-ly by botulinum toxin type A%A型肉毒毒素对神经病理性疼痛模型大鼠P物质含量的影响

    Institute of Scientific and Technical Information of China (English)

    张晓英; 杨国栋; 潘万龙

    2015-01-01

    目的::研究A型肉毒毒素(botulinum toxin type A,BTX-A)对神经病理性疼痛模型大鼠P物质(substance P,SP)含量的影响。方法:5%福尔马林50μL皮下注射于大鼠额区及颞区,建立疼痛模型。 BTX-A组局部皮下注射10 U/kg BTX-A,同时设立生理盐水组及空白对照组,放射免疫法测定SP 含量。结果:生理盐水组SP 含量高于空白对照组( P<0.05), BTX-A组低于生理盐水组(P<0.05)。结论: BTX-A可能通过抑制感觉通路神经肽-SP的释放减轻神经病理性疼痛症状。%Objective:To detect the change of substance P in neuropathic pain rats injected subcutaneously by botulinum toxin type A. Methods:Besides control group,neuropathic pain rats triggered by 5 % formalin subcutaneously injected into frontal and tem-poral areas,then they had been respectively treated with 0. 9 % NaCl (n=10)and 10 U/kg BTX-A (n=10) for 6 days. All of groups were detected the content of substance P(SP) by radioimmunoassay. Results:The content of SP increased significantly in saline group than that in control group (P<0. 05),but decreased significantly in BTX-A groups than in saline group(P<0. 05). Conclusion:BTX-A could inhibit SP releasing from sensory pathways to relieve the symptoms of neuropathic pain.

  10. Safety of Botulinum Toxin A in Children and Adolescents with Cerebral Palsy in a Pragmatic Setting

    Directory of Open Access Journals (Sweden)

    George Mitsou

    2013-03-01

    Full Text Available This retrospective study aimed to examine the safety of botulinum toxin A (BoNT-A treatment in a paediatric multidisciplinary cerebral palsy clinic. In a sample of 454 patients who had 1515 BoNT-A sessions, data on adverse events were available in 356 patients and 1382 sessions; 51 non-fatal adverse events were reported (3.3% of the total injections number, 8.7% of the patients. On five occasions, the adverse reactions observed in GMFCS V children were attributed to the sedation used (rectal midazolam plus pethidine; buccal midazolam and resulted in prolongation of hospitalization. Of the reactions attributed to the toxin, 23 involved an excessive reduction of the muscle tone either of the injected limb(s or generalized; others included local pain, restlessness, lethargy with pallor, disturbance in swallowing and speech production, seizures, strabismus, excessive sweating, constipation, vomiting, a flu-like syndrome and emerging hypertonus in adjacent muscles. Their incidence was associated with GMFCS level and with the presence of epilepsy (Odds ratio (OR = 2.74 − p = 0.016 and OR = 2.35 − p = 0.046, respectively but not with BoNT-A dose (either total or per kilogram. In conclusion, treatment with BoNT-A was safe; adverse reactions were mostly mild even for severely affected patients. Their appearance did not necessitate major changes in our practice.

  11. Botulinum toxin type A in the treatment of painful adductor muscle contracture after total hip arthroplasty.

    Science.gov (United States)

    Santamato, Andrea; Ranieri, Maurizio; Panza, Francesco; Solfrizzi, Vincenzo; Frisardi, Vincenza; Lapenna, Luisa Maria; Moretti, Biagio; Fiore, Pietro

    2009-10-01

    Painful adductor muscle contracture is an important cause of failure during rehabilitation following total hip arthroplasty (THA). Adductor muscle contracture may be caused by postoperative muscle retractions, adhesive capsulitis, postoperative leg-length inequalities caused by implant failure, or preexisting hip pathologies. A 34-year-old woman experienced a persistent painful contracture into the left adductor magnus muscle after THA. She had no leg-length inequalities and, according to the Medical Research Council scale (grades 0-5), muscle strength of the quadriceps was 5/5 for the right side and 3/5 for the left. The degree of functionality according to the Harris hip score (HHS) was 16/100 in the left hip. The pain level, measured with the visual analog scale (VAS), was 7/10. The patient was unable to fully adhere to the rehabilitation program and walked with a limp during the stance phase of gait. After 7 days of treatment with injections of botulinum toxin type A into the left adductor magnus muscle (dose, 150 UM) and subsequent rehabilitation, a great reduction of painful contracture was observed (VAS score, 2/10). The procedure was well tolerated and no adverse effects were noted. After 20 days, hip articular range of motion and gait had improved (HHS score, 75/100). The clinical effects of botulinum toxin type A were present at 2-month follow-up. This treatment may be a viable alternative for the management of painful adductor muscle contracture after THA, without significant side effects. PMID:19824593

  12. Botulinum Toxin Type A as a Therapeutic Agent against Headache and Related Disorders

    Directory of Open Access Journals (Sweden)

    Siro Luvisetto

    2015-09-01

    Full Text Available Botulinum neurotoxin A (BoNT/A is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a “glamour” drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A.

  13. Botulinum Toxin Type a as a Therapeutic Agent against Headache and Related Disorders.

    Science.gov (United States)

    Luvisetto, Siro; Gazerani, Parisa; Cianchetti, Carlo; Pavone, Flaminia

    2015-09-01

    Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a "glamour" drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A.

  14. Botulinum Toxin Type a as a Therapeutic Agent against Headache and Related Disorders.

    Science.gov (United States)

    Luvisetto, Siro; Gazerani, Parisa; Cianchetti, Carlo; Pavone, Flaminia

    2015-09-01

    Botulinum neurotoxin A (BoNT/A) is a toxin produced by the naturally-occurring Clostridium botulinum that causes botulism. The potential of BoNT/A as a useful medical intervention was discovered by scientists developing a vaccine to protect against botulism. They found that, when injected into a muscle, BoNT/A causes a flaccid paralysis. Following this discovery, BoNT/A has been used for many years in the treatment of conditions of pathological muscle hyperactivity, like dystonias and spasticities. In parallel, the toxin has become a "glamour" drug due to its power to ward off facial wrinkles, particularly frontal, due to the activity of the mimic muscles. After the discovery that the drug also appeared to have a preventive effect on headache, scientists spent many efforts to study the potentially-therapeutic action of BoNT/A against pain. BoNT/A is effective at reducing pain in a number of disease states, including cervical dystonia, neuropathic pain, lower back pain, spasticity, myofascial pain and bladder pain. In 2010, regulatory approval for the treatment of chronic migraine with BoNT/A was given, notwithstanding the fact that the mechanism of action is still not completely elucidated. In the present review, we summarize experimental evidence that may help to clarify the mechanisms of action of BoNT/A in relation to the alleviation of headache pain, with particular emphasis on preclinical studies, both in animals and humans. Moreover, we summarize the latest clinical trials that show evidence on headache conditions that may obtain benefits from therapy with BoNT/A. PMID:26404377

  15. Arrangement of the Clostridium baratii F7 toxin gene cluster with identification of a σ factor that recognizes the botulinum toxin gene cluster promoters.

    Science.gov (United States)

    Dover, Nir; Barash, Jason R; Burke, Julianne N; Hill, Karen K; Detter, John C; Arnon, Stephen S

    2014-01-01

    Botulinum neurotoxin (BoNT) is the most poisonous substances known and its eight toxin types (A to H) are distinguished by the inability of polyclonal antibodies that neutralize one toxin type to neutralize any of the other seven toxin types. Infant botulism, an intestinal toxemia orphan disease, is the most common form of human botulism in the United States. It results from swallowed spores of Clostridium botulinum (or rarely, neurotoxigenic Clostridium butyricum or Clostridium baratii) that germinate and temporarily colonize the lumen of the large intestine, where, as vegetative cells, they produce botulinum toxin. Botulinum neurotoxin is encoded by the bont gene that is part of a toxin gene cluster that includes several accessory genes. We sequenced for the first time the complete botulinum neurotoxin gene cluster of nonproteolytic C. baratii type F7. Like the type E and the nonproteolytic type F6 botulinum toxin gene clusters, the C. baratii type F7 had an orfX toxin gene cluster that lacked the regulatory botR gene which is found in proteolytic C. botulinum strains and codes for an alternative σ factor. In the absence of botR, we identified a putative alternative regulatory gene located upstream of the C. baratii type F7 toxin gene cluster. This putative regulatory gene codes for a predicted σ factor that contains DNA-binding-domain homologues to the DNA-binding domains both of BotR and of other members of the TcdR-related group 5 of the σ70 family that are involved in the regulation of toxin gene expression in clostridia. We showed that this TcdR-related protein in association with RNA polymerase core enzyme specifically binds to the C. baratii type F7 botulinum toxin gene cluster promoters. This TcdR-related protein may therefore be involved in regulating the expression of the genes of the botulinum toxin gene cluster in neurotoxigenic C. baratii.

  16. God behandlingseffekt af botulinum toxin A hos systemisk sklerodermi patienter med digitale sår

    DEFF Research Database (Denmark)

    Nielsen, Jane Baumgartner; Hvid, Lone; Olesen, Anne Braae

    2014-01-01

    In this case we describe a successful combined treatment with local anaesthetics and botulinum toxin A. A 61-year-old man with systemic sclerosis of limited type presented treatment refractory digital ulcers on his toes with a poor response to conventional treatment. A combined treatment as above......-mentioned prevented a threatening amputation and improved quality of life, reduction of pain and healing of wounds. Using botulinum toxin A combined with local anaesthetics to severe toe digital ulcers in patients with systemic sclerosis may be a solution, when other treatments have been ineffective and amputation...

  17. Cellular and Matrix Response of the Mandibular Condylar Cartilage to Botulinum Toxin

    Science.gov (United States)

    Dutra, Eliane H.; O’ Brien, Mara H.; Lima, Alexandro; Kalajzic, Zana; Tadinada, Aditya; Nanda, Ravindra; Yadav, Sumit

    2016-01-01

    Objectives To evaluate the cellular and matrix effects of botulinum toxin type A (Botox) on mandibular condylar cartilage (MCC) and subchondral bone. Materials and Methods Botox (0.3 unit) was injected into the right masseter of 5-week-old transgenic mice (Col10a1-RFPcherry) at day 1. Left side masseter was used as intra-animal control. The following bone labels were intraperitoneally injected: calcein at day 7, alizarin red at day 14 and calcein at day 21. In addition, EdU was injected 48 and 24 hours before sacrifice. Mice were sacrificed 30 days after Botox injection. Experimental and control side mandibles were dissected and examined by x-ray imaging and micro-CT. Subsequently, MCC along with the subchondral bone was sectioned and stained with tartrate resistant acid phosphatase (TRAP), EdU, TUNEL, alkaline phosphatase, toluidine blue and safranin O. In addition, we performed immunohistochemistry for pSMAD and VEGF. Results Bone volume fraction, tissue density and trabecular thickness were significantly decreased on the right side of the subchondral bone and mineralized cartilage (Botox was injected) when compared to the left side. There was no significant difference in the mandibular length and condylar head length; however, the condylar width was significantly decreased after Botox injection. Our histology showed decreased numbers of Col10a1 expressing cells, decreased cell proliferation and increased cell apoptosis in the subchondral bone and mandibular condylar cartilage, decreased TRAP activity and mineralization of Botox injected side cartilage and subchondral bone. Furthermore, we observed reduced proteoglycan and glycosaminoglycan distribution and decreased expression of pSMAD 1/5/8 and VEGF in the MCC of the Botox injected side in comparison to control side. Conclusion Injection of Botox in masseter muscle leads to decreased mineralization and matrix deposition, reduced chondrocyte proliferation and differentiation and increased cell apoptosis in the

  18. CLINICAL APPLICATION OF BOTULINUM TOXIN TYPE B IN MOVEMENT DISORDERS AND AUTONOMIC SYMPTOMS

    Institute of Scientific and Technical Information of China (English)

    Xin-hua Wan; Kevin Dat Vuong; Joseph Jankovic

    2005-01-01

    Objective To evaluate efficacy and safety of botulinum toxin type B (BTX-B) in treatment of movement disorders including blepharospasm, oromandibular dystonia, hemifacial spasm, tremor, tics, and hypersecretory disorders such as sialorrhea and hyperhidrosis.Methods A retrospective study of BTX-B injections in treatment of 58 patients with various neurological disorders was performed. The mean follow-up time was 0.9 ± 0.8 years. Results of the first and last treatment of patients with at least 3injection sessions were compared.Results The response of 58 patients to a total of 157 BTX-B treatment sessions was analyzed. Of the 157 treatment sessions, 120 sessions (76.4%) resulted in moderate or marked improvement while 17 sessions (10.8%) had no response.The clinical benefits after BTX-B treatment lasted an average of 14 weeks. Of the 41 patients with at least 3 injection sessions (mean 10 ± 8.6), most patients needed increased dosage upon the last session compared to the first session. Nineteen patients (32.8%) with 27 sessions (17.2%) reported adverse effects with BTX-B treatment.Conclusios Though most patients require increased dosage to maintain effective response after repeated injections,BTX-B is an effective and safe treatment drug for a variety of movement disorders, as well as drooling and hyperhidrosis.

  19. An Open Study of Botulinum-A Toxin Treatment of Idiopathic Trigeminal Neuralgia

    Directory of Open Access Journals (Sweden)

    Karim Nikkhah

    2015-07-01

    Full Text Available Introduction: Trigeminal Neuralgia (TN is a unilateral, recurrent, sharp facial pain disorder that is limited to the distribution of divisions of the trigeminal nerve. The aim of this study was to evaluate the efficacy of Botulinum neurotoxin type A (BTX-A for alleviating the frequency and severity of TN pain. Materials and Methods: This trial was performed as a before and after study. We treated 31 patients (15 male and 16 female with mean age of 52 year old that their diagnosis was made at least 4.5 years before. We injected BTX-A in various parts of face and particularly in the origin of mandibular and maxillary branches of trigeminal nerve. Injection volume was determined by the necessity and pain intensity measured with visual analog scale up to 100U. Patients were evaluated before and after the injection and were followed after week, and each month, for a three months period. Other related variables were recorded such as: toxin complications, pain status variations by brushing, chewing, cold weather and patient’s satisfaction with their therapy. Results: showed that after injection, pain intensity and frequency decreased after tooth brushing, chewing and cold weather (P

  20. Botulinum toxin type A normalizes alterations in urothelial ATP and NO release induced by chronic spinal cord injury

    OpenAIRE

    Smith, Christopher P.; Gangitano, David A; Munoz, Alvaro; Salas, Nilson A.; Boone, Timothy B.; Aoki, K Roger; Francis, Joseph; Somogyi, George T.

    2007-01-01

    The purpose of this paper was to simultaneously examine changes in urothelial ATP and NO release in normal and spinal cord injured animals as well as in spinal cord injured animals treated with botulinum toxin type A (BoNT-A). Furthermore we correlated changes in transmitter release with functional changes in bladder contraction frequency, and determined the effects of BoNT-A on bladder efferent nerve function. Normal and spinal cord injured rat bladders were injected on day 0 with either veh...

  1. Botulinum toxin treatment of pes cavovarus in a child suffering from autosomal recessive axonal Charcot-Marie-Tooth neuropathy (AR-CMT2).

    Science.gov (United States)

    Tiffreau, V; Allart, E; Dangleterre, C; Boutry, N; Petit, F; Cuisset, J M; Thevenon, A

    2015-06-01

    In a 12-year old girl suffering from autosomal recessive axonal Charcot-Marie-Tooth (CMT) neuropathy, pes cavovarus was treated with botulinum toxin injection in the tibialis posterior. The patient underwent a clinical evaluation, video analysis of spatiotemporal gait parameters and dynamic foot plantar pressure assessment before treatment and then two weeks, three months and six months thereafter. The video gait analysis revealed a decrease in varus during the swing phase of gait. The dynamic foot plantar pressure decreased by 50% in the excessive pressure at the side of the foot six months after the injection (maximal pressure=42.6N/cm2 before treatment and 18.9 N/cm2 after 6 month). Botulinum toxin injection appears to be an efficacious means of correcting pes cavovarus in CMT disease. A larger-scale clinical trial is now required to evaluate the putative longer-term preventive effect of this treatment on the pes cavus deformity. PMID:24980632

  2. Beneficial effects of botulinum toxin type A in trigeminal neuralgia Beneficio de la toxina botulínica tipo A en neuralgia del trigemino

    Directory of Open Access Journals (Sweden)

    Carlos Zúñiga

    2008-09-01

    Full Text Available Botulinum toxin has been thoroughly studied as a potential tool in the treatment of several pain syndromes. Therefore, we assessed the clinical effects of botulinum toxin type A injections in 12 patients with otherwise unresponsive idiopathic trigeminal neuralgia. Patients were infiltrated with 20-50 units of botulinum toxin in trigger zones. Those who presented with mandibular involvement were also infiltrated in the masseter muscle. The patients were assessed on a weekly basis using the Visual Analogic Scale for pain. Ten of our patients reported a significant benefit from botulinum toxin injections, with reduction or even disappearance of pain, and remained pain free for as long as 60 days. Our findings suggest that botulinum toxin may represent a useful therapeutic tool in the management of patients with this entity.La toxina botulínica ha sido estudiada en forma exhaustiva como una potencial herramienta en el tratamiento de múltiples síndromes dolorosos. Por lo tanto, evaluamos los efectos clínicos de la aplicación de toxina botulínica tipo A en 12 sujetos con neuralgia trigeminal idiopática resistente a manejo farmacológico. Se aplicaron en dichos sujetos entre 20 y 50 unidades de toxina botulínica tipo A en las zonas gatillo. Además se infiltró el músculo masetero en aquellos que presentaban involucro mandibular. Los sujetos fueron evaluados semanalmente con una escala visual análoga para dolor. Diez de los sujetos reportaron un beneficio significativo con el uso de toxina botulínica, con reducción e incluso desaparición del dolor, permaneciendo libres de dolor por un periodo de hasta 60 días. Nuestros hallazgos sugieren que la toxina botulínica puede representar una herramienta terapéutica útil en el manejo de pacientes con esta entidad.

  3. 不同定位技术引导A型肉毒毒素注射治疗脑卒中后足下垂内翻的效果%Comparison of Location Guided by Palpation, Ultrasound and Electromyography in Botulinum Toxin Type A In-jection for Equinovarus in Stroke

    Institute of Scientific and Technical Information of China (English)

    欧海宁; 黄彬; 周凯欣; 黄卓群; 邓万溪; 卢伟焰

    2015-01-01

    Objective To compare the clinical effects of palpation, ultrasound and electromyography (EMG) guided injection of botuli-num toxin type A (BTX-A) on spastic equinovarus in stroke patients. Methods Stroke patients with equinovarus were randomly assigned to palpation-guided group (n=19), ultrasound-guided group (n=21) and EMG-guided group (n=19). All of the patients received injection of BTX-A 300 U in gastrocnemius, soleus and tibialis posterior, guided in their own ways. They were measured with modified Ashworth Scale (MAS), Physician Rating Scale (PRS), speed of gait, passive range of motion (PROM) of ankle dorsiflexion and eversion before and 2 weeks, 4 weeks, 8 weeks, and 12 weeks after injection. Results Compared with the baseline, all the indexes significantly improved after in-jection in all the groups (P0.05).结论 三种定位技术引导下注射BTX-A均能改善患者痉挛和步行能力,超声引导比肌电图引导在改善足内翻方面稍有优势,均优于徒手定位.

  4. Botulinum toxin type A products are not interchangeable: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Brin MF

    2014-10-01

    Full Text Available Mitchell F Brin,1,2 Charmaine James,3 John Maltman1 1Allergan, Inc., Irvine, CA, USA; 2Department of Neurology, University of California, Irvine, CA, USA; 3Allergan, Marlow, UKAbstract: Botulinum toxin type A (BoNTA products are injectable biologic medications derived from Clostridium botulinum bacteria. Several different BoNTA products are marketed in various countries, and they are not interchangeable. Differences between products include manufacturing processes, formulations, and the assay methods used to determine units of biological activity. These differences result in a specific set of interactions between each BoNTA product and the tissue injected. Consequently, the products show differences in their in vivo profiles, including preclinical dose response curves and clinical dosing, efficacy, duration, and safety/adverse events. Most, but not all, published studies document these differences, suggesting that individual BoNTA products act differently depending on experimental and clinical conditions, and these differences may not always be predictable. Differentiation through regulatory approvals provides a measure of confidence in safety and efficacy at the specified doses for each approved indication. Moreover, the products differ in the amount of study to which they have been subjected, as evidenced by the number of publications in the peer-reviewed literature and the quantity and quality of clinical studies. Given that BoNTAs are potent biological products that meet important clinical needs, it is critical to recognize that their dosing and product performance are not interchangeable and each product should be used according to manufacturer guidelines.Keywords: onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, glabellar lines, non-interchangeability

  5. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

    Science.gov (United States)

    Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

    2015-09-01

    Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time. PMID:25966878

  6. An in vivo analysis of facial muscle change treated with botulinum toxin type A using digital image speckle correlation

    Science.gov (United States)

    Xu, Yan; Palmaccio, Samantha Palmaccio; Bui, Duc; Dagum, Alexander; Rafailovich, Miriam

    Been famous for clinical use from early 1980s, the neuromuscular blocking agent Botulinum toxin type A (BTX-A), has been used to reduce wrinkles for a long time. Only little research has been done to quantify the change of muscle contraction before and after injection and most research paper depend on subjective evaluation from both patients and surgeons. In our research, Digital Image Speckle Correlation (DISC) was employed to study the mechanical properties of skin, contraction mode of muscles (injected) and reaction of neighbor muscle group (un-injected).At the same time, displacement patterns (vector maps)generated by DISC can predict injection locus for surgeons who normally handle it depending only on visual observation.

  7. British Neurotoxin Network recommendations for managing cervical dystonia in patients with a poor response to botulinum toxin

    Science.gov (United States)

    Marion, Marie-Helene; Humberstone, Miles; Grunewald, Richard; Wimalaratna, Sunil

    2016-01-01

    Botulinum toxin (BoNT) injections are an effective treatment for cervical dystonia. Approximately 20% of patients eventually stop BoNT treatment, mostly because of treatment failure. These recommendations review the different therapeutic interventions for optimising the treatment in secondary poor responder patients. Immunoresistance has become less common over the years, but the diagnosis has to be addressed with a frontalis test or an Extensor Digitorum Brevis test. In case of immunoresistance to BoNT-A, we discuss the place the different therapeutic options (BoNT-A holidays, BoNT-B injections, alternative BoNT-A injections, deep brain stimulation). When poor responders are not immunoresistant, they benefit from reviewing (1) injections technique with electromyography or ultrasound guidance, (2) muscles selection and (3) dose of BoNT. In addition, in both scenarios, a holistic approach including drug treatment, retraining and psychological support is valuable in the management of these complex and severe cervical dystonia. PMID:26976927

  8. Botulinum toxin A for treatment of masseteric muscle hypertrophy%A型肉毒素治疗咬肌肥大的疗效研究

    Institute of Scientific and Technical Information of China (English)

    刘江

    2014-01-01

    目的:分析A型肉毒素治疗咬肌肥大的疗效。方法对在本科室治疗的25名咬肌肥大的患者进行A型肉毒素治疗咬肌肥大。20例双侧咬肌肥大注射50U/1ml.5例单侧咬肌肥大患者注射60U/1ml,观察治疗前后咬肌厚度的变化情况。结果接受A型肉毒素治疗后,患者咬肌厚度均有不同程度的减少,治疗后一个月至3个月咬肌厚度减少程度明显。结论 A型肉毒素可较好的治疗咬肌肥大。%Objective To assess the therapeutic effect of botulinum toxin A in treating masseteric muscle hypertrophy. Methods 25 patients with masseteric muscle hypertrophy were injected botulinum toxin A. 20 patients with bilateral masseteric hypertrophy were injected 50U/1ml;5 patients with unilaterial hypertrophy were injected 60U/1ml. The masseter thickness of all patients were recorded at different time. Results The masseter thickness were reduced significantly after injection of botulinum toxin A. The maximum reduction of masseter thickness was 1-3 months after injection. Conclusion Botulinum Toxin A is an effective treatment for masseteric muscle hypertrophy.

  9. Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy

    DEFF Research Database (Denmark)

    Bandholm, Thomas Quaade; Jensen, Bente Rona; Nielsen, Lone M;

    2012-01-01

    Objective: To compare the effects of physical rehabilitation with (PRT) and without (CON) progressive resistance training following treatment of spastic plantarflexors with botulinum toxin type A (BoNT) in children with cerebral palsy (CP). Methods: Fourteen children with CP performed supervised...

  10. Cellular uptake of Clostridium botulinum C2 toxin requires oligomerization and acidification

    NARCIS (Netherlands)

    Barth, H; Blocker, D; Behlke, J; Bergsma-Schutter, W; Brisson, A; Benz, R; Aktories, K

    2000-01-01

    The actin-ADP-ribosylating binary Clostridium botulinum C2 toxin consists of two individual proteins, the binding/translocation component C2II and the enzyme component C2I. To elicit its cytotoxic action, C2II binds to a receptor on the cell surface and mediates cell entry of C2I via receptor-mediat

  11. The use of botulinum toxin type A in cosmetic facial procedures

    NARCIS (Netherlands)

    Jaspers, G. W. C.; Pijpe, J.; Jansma, J.

    2011-01-01

    Over the past decade, facial cosmetic procedures have become more commonplace ill dentistry and oral and maxillofacial surgery. An increasing number of patients seek minimal invasive procedures. One of the most requested procedures is treatment with botulinum toxin type A (BoNTA). Treatment of dynam

  12. Effect of multilevel botulinum toxin A and comprehensive rehabilitation on gait in cerebral palsy

    NARCIS (Netherlands)

    Scholtes, Vanessa A.; Dallmeijer, Annet J.; Knol, Dirk L.; Speth, Lucianne A.; Maathuis, Carel G.; Jongerius, Peter H.; Becher, Jules G.

    2007-01-01

    To evaluate the effect of multilevel botulinum toxin A and comprehensive rehabilitation on gait pattern, muscle length, and spasticity, a multicenter randomized trial was performed in 46 children with spastic cerebral palsy who walk with flexed knees. Their mean age was 8.0 years (range 4 to 11 year

  13. A型肉毒毒素在斜视治疗中的应用%Botulinum toxin A in treatmen of the strabismus

    Institute of Scientific and Technical Information of China (English)

    王贝贝; 胡依博; 王素萍(综述); 王瑞峰(审校)

    2016-01-01

    Botulinum toxin A injections the extraocular muscles which can cause temporary paralysis to change the positiong of eye in order to treatment of strabismus.And it can produce the extraocular muscle temporary weakness and permanent eye position change, with the advantages of repeated injections, simple operation and less side effects, etc. In this paper, botulinum toxin type A application in strabismus treatment were summarized.%肉毒毒素A型注射眼外肌可造成暂时性麻痹来改变眼位治疗斜视,可产生眼外肌暂时的无力和永久的眼位改变,并具有可重复注射,操作简单和副作用少等优点。本文对肉毒毒素A型在斜视治疗中的应用进行综述。

  14. Primary hyperhidrosis: Implications on symptoms, daily life, health and alcohol consumption when treated with botulinum toxin.

    Science.gov (United States)

    Shayesteh, Alexander; Boman, Jens; Janlert, Urban; Brulin, Christine; Nylander, Elisabet

    2016-08-01

    Primary hyperhidrosis affects approximately 3% of the population and reduces quality of life in affected persons. Few studies have investigated the symptoms of anxiety, depression and hazardous alcohol consumption among those with hyperhidrosis and the effect of treatment with botulinum toxin. The first aim of this study was to investigate the effect of primary hyperhidrosis on mental and physical health, and alcohol consumption. Our second aim was to study whether and how treatment with botulinum toxin changed these effects. One hundred and fourteen patients answered questionnaires regarding hyperhidrosis and symptoms, including hyperhidrosis disease severity scale (HDSS), visual analog scale (VAS) 10-point scale for hyperhidrosis symptoms, hospital anxiety and depression scale (HADS), alcohol use disorder identification test (AUDIT) and short-form health survey (SF-36) before treatment with botulinum toxin and 2 weeks after. The age of onset of hyperhidrosis was on average 13.4 years and 48% described heredity for hyperhidrosis. Significant improvements were noted in patients with axillary and palmar hyperhidrosis regarding mean HDSS, VAS 10-point scale, HADS, SF-36 and sweat-related health problems 2 weeks after treatment with botulinum toxin. Changes in mean AUDIT for all participants were not significant. Primary hyperhidrosis mainly impairs mental rather than physical aspects of life and also interferes with specific daily activities of the affected individuals. Despite this, our patients did not show signs of anxiety, depression or hazardous alcohol consumption. Treatment with botulinum toxin reduced sweat-related problems and led to significant improvements in HDSS, VAS, HADS and SF-36 in our patients. PMID:26875781

  15. 小针高频电凝配合注射肉毒杆菌毒素A诱导家兔咬肌萎缩的实验研究%Experiment of Rabbit Masseter Muscle Atrophy Induced by High-frequency Electric Coagulation of Small Needle with Injection of Botulinum Toxin A

    Institute of Scientific and Technical Information of China (English)

    秦子侃; 刘庆丰; 林瑞英; 王海

    2011-01-01

    目的 探讨小针高频电凝配合肉毒毒素A治疗咬肌肥大的可行性.方法 健康家兔36只,随机分为4组,每组9只;A组在咬肌注射肉毒毒素A 2 U/kg;B组于咬肌插入数枚电凝针,20 W电凝3 s;C组为A组注射剂量为1 U/kg,联合高频电凝20 W,3 s;D组为空白对照组.A组、B组、C组治疗对侧注射等量生理盐水做自身对照.于实验后4周、8周、12周取咬肌,通过肉眼观、测量咬肌湿重、B超探测咬肌厚度及组织染色镜下观察其结构的变化,观察其对咬肌萎缩的疗效.结果 在C组、A组、B组均引起实验侧咬肌厚度变薄、湿重减小,但C组诱导的肌肉萎缩最为明显,差异有统计学意义(P<0.05).镜下见肌纤维变细,排列更加紧密,电凝区组织坏死纤维机化.结论 高频电凝联合肉毒毒素A作用于肌肉组织,能使肌纤维变细,排列更加紧密,部分肌纤维坏死机化;咬肌厚度变薄,湿重减小,对肌组织的萎缩更明显,可为临床治疗良性咬肌肥大提供有益的启示.%Objective To investigate a new method of minimally invasive treatment of benign masseteric hypertrophy.Methods Thirty six rabbits were randomly divided int0 4 groups , Group A( n =9 )was injected 2 U /kg botulinum toxin on rabbit masseter muscle;group B( n =9 )was injected several pieces of electro coagulation needles on the masseter muscle;group C( n =9 )was treated together with 1 U/kg botulinum toxin and high-frequency electro coagulation 20 W,3 seconds;group D( n =9 )was the control group. All the rabbits in group A,group B and group C were injected with nomal saline on the opposite side After 4 weeks ,8 weeks and 12 weeks ,the masseter muscle was evaluated by naked eye observation,the wet weigh was measured, the thickness by B Type Ultrasonography and their changes in its structure were observed under staining microscope , and the effect on the masseter muscle atrophy was analyzed. Results The thickness of masseter muscle in group A

  16. Efficacy and Safety of Botulinum Toxin A for Treating Bladder Hyperactivity in Children and Adolescents with Neuropathic Bladder Secondary to Myelomeningocele

    OpenAIRE

    Marte, Antonio; Borrelli, Micaela; Prezioso, Maurizio; Pintozzi, Lucia; Parmeggiani, Pio

    2013-01-01

    We verified the efficacy and safety of botulinum toxin A (BTX-A) in treating bladder overactivity in children with neurogenic bladder (NB) secondary to myelomeningocele (MMC). Forty-seven patients (22, females; 25, males; age range, 5–17 years; mean age, 10.7 years) with poorly compliant/overactive neurogenic bladder on clean intermittent catheterization (CIC) and resistance or noncompliant to anticholinergics were injected with 200 IU of BTX-A intradetrusor. All patients experienced a signif...

  17. Toxina botulínica y su empleo en la patología oral y maxilofacial Botulinum toxin and its use in oral and maxillofacial pathology

    Directory of Open Access Journals (Sweden)

    D. Martínez-Pérez

    2004-06-01

    Full Text Available Resumen: Las toxinas botulínicas son exotoxinas de la bacteria formadora de esporas Clostridim botulinum y los agentes causantes del botulismo. Cuando se inyecta en el músculo produce una parálisis flácida. El efecto clínico está directamente relacionado con la dosis y debe ajustarse para cada caso concreto. La Toxina botulínica ha demostrado en los más de veinte años en que se está utilizando que es un fármaco seguro. Las indicaciones de la toxina botulínica en la actualidad incluyen todas aquellas patologías que resultan de la hiperfunción muscular y la disfunción autonómica.Abstract: Botilinum toxins are exotoxins of the bacteria that form the Clostridium botulinum spores and the causative agents of botulism. When injected into the muscle flaccid paralysis is produced. The clinical effect is directly related with the dose and is should be adjusted for each particular case. over the last twenty years that it has been in use, the botulinum toxin has shown itself to be a reliable drug. Current indications for the use of botulinum toxin include all those pathologies which are the results of muscle hyperfunction and autonomic dysfunction.

  18. Unique use of botulinum toxin to decrease adductor tone and allow surgical excision of vulvar carcinoma.

    Science.gov (United States)

    Guo, Y; Shin, K

    2004-01-01

    Here, we present the case of an 86-year-old woman with vulvar carcinoma requiring surgical resection and with Parkinson's disease with severe spasticity and contractures of the lower extremities. Because of the patient's severe contractures and spasticity (her knees could only be separated by 2 cm with sustained abducting force), surgical positioning and access to the vulva were impossible. The patient was admitted, intending to undergo surgery after injection with botulinum toxin (BTX) to hip adductors and intensive physical therapy. After confirmed healed hip arthroplasty, the patient underwent BTX injection (400 U) to her bilateral adductor brevis, adductor longus, adductor magnus, and semimembranosus and semitendinosus muscles on day 2 of her hospital stay. On day 3, a physical therapist began a twice-a-day stretching program. An adjustable abduction brace was custom-made to provide sustained stretching. On day 9, the patient underwent wide local excision of vulvar carcinoma with the abductor brace in place. The patient tolerated the surgery well and was discharged home on day 11 with continuous physical therapy. Upon discharge, the distance between the patient's knees was 14 cm. This unique case demonstrated a new indication for BTX treatment in the preoperative setting to allow surgical positioning and access.

  19. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins

    Directory of Open Access Journals (Sweden)

    Hyun-Mi Oh

    2015-12-01

    Full Text Available MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH and abductor digiti quinti (ADQ muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect.

  20. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins.

    Science.gov (United States)

    Oh, Hyun-Mi; Park, Joo Hyun; Song, Dae Heon; Chung, Myung Eun

    2016-01-01

    MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB) muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX) was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH) and abductor digiti quinti (ADQ) muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP) amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA) differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect. PMID:26712786

  1. “Non-Toxic” Proteins of the Botulinum Toxin Complex Exert In-vivo Toxicity

    Science.gov (United States)

    Miyashita, Shin-Ichiro; Sagane, Yoshimasa; Suzuki, Tomonori; Matsumoto, Takashi; Niwa, Koichi; Watanabe, Toshihiro

    2016-01-01

    The botulinum neurotoxin (BoNT) causes muscle paralysis and is the most potent toxin in nature. BoNT is associated with a complex of auxiliary “Non-Toxic” proteins, which constitute a large-sized toxin complex (L-TC). However, here we report that the “Non-Toxic” complex of serotype D botulinum L-TC, when administered to rats, exerts in-vivo toxicity on small-intestinal villi. Moreover, Serotype C and D of the “Non-Toxic” complex, but not BoNT, induced vacuole-formation in a rat intestinal epithelial cell line (IEC-6), resulting in cell death. Our results suggest that the vacuole was formed in a manner distinct from the mechanism by which Helicobacter pylori vacuolating toxin (VacA) and Vibrio cholerae haemolysin induce vacuolation. We therefore hypothesise that the serotype C and D botulinum toxin complex is a functional hybrid of the neurotoxin and vacuolating toxin (VT) which arose from horizontal gene transfer from an ancestral BoNT-producing bacterium to a hypothetical VT-producing bacterium. PMID:27507612

  2. "Non-Toxic" Proteins of the Botulinum Toxin Complex Exert In-vivo Toxicity.

    Science.gov (United States)

    Miyashita, Shin-Ichiro; Sagane, Yoshimasa; Suzuki, Tomonori; Matsumoto, Takashi; Niwa, Koichi; Watanabe, Toshihiro

    2016-01-01

    The botulinum neurotoxin (BoNT) causes muscle paralysis and is the most potent toxin in nature. BoNT is associated with a complex of auxiliary "Non-Toxic" proteins, which constitute a large-sized toxin complex (L-TC). However, here we report that the "Non-Toxic" complex of serotype D botulinum L-TC, when administered to rats, exerts in-vivo toxicity on small-intestinal villi. Moreover, Serotype C and D of the "Non-Toxic" complex, but not BoNT, induced vacuole-formation in a rat intestinal epithelial cell line (IEC-6), resulting in cell death. Our results suggest that the vacuole was formed in a manner distinct from the mechanism by which Helicobacter pylori vacuolating toxin (VacA) and Vibrio cholerae haemolysin induce vacuolation. We therefore hypothesise that the serotype C and D botulinum toxin complex is a functional hybrid of the neurotoxin and vacuolating toxin (VT) which arose from horizontal gene transfer from an ancestral BoNT-producing bacterium to a hypothetical VT-producing bacterium. PMID:27507612

  3. Botulinum toxin type A for neuropathic pain in patients with spinal cord injury

    Science.gov (United States)

    Han, Zee‐A; Song, Dae Heon; Oh, Hyun‐Mi

    2016-01-01

    Objective To evaluate the analgesic effect of botulinum toxin type A (BTX‐A) on patients with spinal cord injury‐associated neuropathic pain. Methods The effect of BTX‐A on 40 patients with spinal cord injury‐associated neuropathic pain was investigated using a randomized, double‐blind, placebo‐controlled design. A 1‐time subcutaneous BTX‐A (200U) injection was administered to the painful area. Visual analogue scale (VAS) scores (0–100mm), the Korean version of the short‐form McGill Pain Questionnaire, and the World Health Organization WHOQOL‐BREF quality of life assessment were evaluated prior to treatment and at 4 and 8 weeks after the injection. Results At 4 and 8 weeks after injection, the VAS score for pain was significantly reduced by 18.6 ± 16.8 and 21.3 ± 26.8, respectively, in the BTX‐A group, whereas it was reduced by 2.6 ± 14.6 and 0.3 ± 19.5, respectively, in the placebo group. The pain relief was associated with preservation of motor or sensory function below the neurological level of injury. Among the responders in the BTX‐A group, 55% and 45% reported pain relief of 20% or greater at 4 and 8 weeks, respectively, after the injection, whereas only 15% and 10% of the responders in the placebo group reported a similar level of pain relief. Improvements in the score for the physical health domain of the WHOQOL‐BREF in the BTX‐A group showed a marginal trend toward significance (p = 0.0521) at 4 weeks after the injection. Interpretation These results indicate that BTX‐A may reduce intractable chronic neuropathic pain in patients with spinal cord injury. Ann Neurol 2016;79:569–578 PMID:26814620

  4. Botulinum toxin detection using AlGaN /GaN high electron mobility transistors

    Science.gov (United States)

    Wang, Yu-Lin; Chu, B. H.; Chen, K. H.; Chang, C. Y.; Lele, T. P.; Tseng, Y.; Pearton, S. J.; Ramage, J.; Hooten, D.; Dabiran, A.; Chow, P. P.; Ren, F.

    2008-12-01

    Antibody-functionalized, Au-gated AlGaN /GaN high electron mobility transistors (HEMTs) were used to detect botulinum toxin. The antibody was anchored to the gate area through immobilized thioglycolic acid. The AlGaN /GaN HEMT drain-source current showed a rapid response of less than 5s when the target toxin in a buffer was added to the antibody-immobilized surface. We could detect a range of concentrations from 1to10ng/ml. These results clearly demonstrate the promise of field-deployable electronic biological sensors based on AlGaN /GaN HEMTs for botulinum toxin detection.

  5. Kinetic and Reaction Pathway Analysis in the Application of Botulinum Toxin A for Wound Healing

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    Frank J. Lebeda

    2012-01-01

    Full Text Available A relatively new approach in the treatment of specific wounds in animal models and in patients with type A botulinum toxin is the focus of this paper. The indications or conditions include traumatic wounds (experimental and clinical, surgical (incision wounds, and wounds such as fissures and ulcers that are signs/symptoms of disease or other processes. An objective was to conduct systematic literature searches and take note of the reactions involved in the healing process and identify corresponding pharmacokinetic data. From several case reports, we developed a qualitative model of how botulinum toxin disrupts the vicious cycle of muscle spasm, pain, inflammation, decreased blood flow, and ischemia. We transformed this model into a minimal kinetic scheme for healing chronic wounds. The model helped us to estimate the rate of decline of this toxin's therapeutic effect by calculating the rate of recurrence of clinical symptoms after a wound-healing treatment with this neurotoxin.

  6. EGA Protects Mammalian Cells from Clostridium difficile CDT, Clostridium perfringens Iota Toxin and Clostridium botulinum C2 Toxin

    Science.gov (United States)

    Schnell, Leonie; Mittler, Ann-Katrin; Sadi, Mirko; Popoff, Michel R.; Schwan, Carsten; Aktories, Klaus; Mattarei, Andrea; Tehran, Domenico Azarnia; Montecucco, Cesare; Barth, Holger

    2016-01-01

    The pathogenic bacteria Clostridium difficile, Clostridium perfringens and Clostridium botulinum produce the binary actin ADP-ribosylating toxins CDT, iota and C2, respectively. These toxins are composed of a transport component (B) and a separate enzyme component (A). When both components assemble on the surface of mammalian target cells, the B components mediate the entry of the A components via endosomes into the cytosol. Here, the A components ADP-ribosylate G-actin, resulting in depolymerization of F-actin, cell-rounding and eventually death. In the present study, we demonstrate that 4-bromobenzaldehyde N-(2,6-dimethylphenyl)semicarbazone (EGA), a compound that protects cells from multiple toxins and viruses, also protects different mammalian epithelial cells from all three binary actin ADP-ribosylating toxins. In contrast, EGA did not inhibit the intoxication of cells with Clostridium difficile toxins A and B, indicating a possible different entry route for this toxin. EGA does not affect either the binding of the C2 toxin to the cells surface or the enzyme activity of the A components of CDT, iota and C2, suggesting that this compound interferes with cellular uptake of the toxins. Moreover, for C2 toxin, we demonstrated that EGA inhibits the pH-dependent transport of the A component across cell membranes. EGA is not cytotoxic, and therefore, we propose it as a lead compound for the development of novel pharmacological inhibitors against clostridial binary actin ADP-ribosylating toxins. PMID:27043629

  7. EGA Protects Mammalian Cells from Clostridium difficile CDT, Clostridium perfringens Iota Toxin and Clostridium botulinum C2 Toxin.

    Science.gov (United States)

    Schnell, Leonie; Mittler, Ann-Katrin; Sadi, Mirko; Popoff, Michel R; Schwan, Carsten; Aktories, Klaus; Mattarei, Andrea; Tehran, Domenico Azarnia; Montecucco, Cesare; Barth, Holger

    2016-04-01

    The pathogenic bacteria Clostridium difficile, Clostridium perfringens and Clostridium botulinum produce the binary actin ADP-ribosylating toxins CDT, iota and C2, respectively. These toxins are composed of a transport component (B) and a separate enzyme component (A). When both components assemble on the surface of mammalian target cells, the B components mediate the entry of the A components via endosomes into the cytosol. Here, the A components ADP-ribosylate G-actin, resulting in depolymerization of F-actin, cell-rounding and eventually death. In the present study, we demonstrate that 4-bromobenzaldehyde N-(2,6-dimethylphenyl)semicarbazone (EGA), a compound that protects cells from multiple toxins and viruses, also protects different mammalian epithelial cells from all three binary actin ADP-ribosylating toxins. In contrast, EGA did not inhibit the intoxication of cells with Clostridium difficile toxins A and B, indicating a possible different entry route for this toxin. EGA does not affect either the binding of the C2 toxin to the cells surface or the enzyme activity of the A components of CDT, iota and C2, suggesting that this compound interferes with cellular uptake of the toxins. Moreover, for C2 toxin, we demonstrated that EGA inhibits the pH-dependent transport of the A component across cell membranes. EGA is not cytotoxic, and therefore, we propose it as a lead compound for the development of novel pharmacological inhibitors against clostridial binary actin ADP-ribosylating toxins. PMID:27043629

  8. EGA Protects Mammalian Cells from Clostridium difficile CDT, Clostridium perfringens Iota Toxin and Clostridium botulinum C2 Toxin

    Directory of Open Access Journals (Sweden)

    Leonie Schnell

    2016-04-01

    Full Text Available The pathogenic bacteria Clostridium difficile, Clostridium perfringens and Clostridium botulinum produce the binary actin ADP-ribosylating toxins CDT, iota and C2, respectively. These toxins are composed of a transport component (B and a separate enzyme component (A. When both components assemble on the surface of mammalian target cells, the B components mediate the entry of the A components via endosomes into the cytosol. Here, the A components ADP-ribosylate G-actin, resulting in depolymerization of F-actin, cell-rounding and eventually death. In the present study, we demonstrate that 4-bromobenzaldehyde N-(2,6-dimethylphenylsemicarbazone (EGA, a compound that protects cells from multiple toxins and viruses, also protects different mammalian epithelial cells from all three binary actin ADP-ribosylating toxins. In contrast, EGA did not inhibit the intoxication of cells with Clostridium difficile toxins A and B, indicating a possible different entry route for this toxin. EGA does not affect either the binding of the C2 toxin to the cells surface or the enzyme activity of the A components of CDT, iota and C2, suggesting that this compound interferes with cellular uptake of the toxins. Moreover, for C2 toxin, we demonstrated that EGA inhibits the pH-dependent transport of the A component across cell membranes. EGA is not cytotoxic, and therefore, we propose it as a lead compound for the development of novel pharmacological inhibitors against clostridial binary actin ADP-ribosylating toxins.

  9. Central antinociceptive activity of botulinum toxin A [Središnje antinociceptivno djelovanje botulinum toksina A

    OpenAIRE

    Matak, Ivica

    2015-01-01

    UVOD I CILJ ISTRAŽIVANJA: Botulinum toksin tipa A (BoNT/A), neurotoksin iz anaerobne bakterije Clostridium botulinum, je jedan od najpotentnijih bioloških toksina. Ulaskom u živčane terminale uzrokuje enzimsko cijepanje sinaptosomalnog proteina molekulske mase od 25 kDa (eng. synaptosomal-associated protein of 25 kDa; SNAP-25), što sprječava lučenje neurotransmitora. Intoksikacija organizma preko hrane ili infekcija sporama bakterija pri određenim uvjetima uzrokuje neuroparalitičku bolest bot...

  10. Study on potential Clostridium botulinum growth and toxin production in Parma ham

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    Giuseppe Merialdi

    2016-04-01

    Full Text Available The objective of this study was to investigate Clostridium botulinum growth and toxin production in the industrially manufactured Italian Parma ham. The study focuses on the Parma ham production phase identified as maximum risk to C. botulinum proliferation, i.e. the transition from cold phase (salting and resting to a phase carried out at temperature between 15 and 23°C (drying. A preliminary in vitro test was carried out in order to verify the capability of 6 C. botulinum strains (1 type A, 4 type B, and 1 type E strains to grow in conditions of temperature, pH and NaCl concentration comparable to those of the beginning stage of ham drying. Five C. botulinum strains grew at 20°C and pH 6, four strains produced toxin when inoculated at a concentration equal to 103 cfu/mL at NaCl concentration of 4%, while when the inoculum concentration was 10 cfu/mL, NaCl concentration of 3% resulted the toxin-genesis limiting factor. An experimental contamination with a mixture of the 5 C. botulinum strains selected by the preliminary in vitro test was performed on 9 thighs inoculated at the end of the resting phase. The study was designed to evaluate the potential growth and toxin production in extremely favourable conditions for the bacterium. Type B proteolytic C. botulinum toxin was produced after 14 days of incubation at 20°C in 2 thighs characterised by high weight, low number of days of resting and anomalous physiochemical characteristics [one for very low NaCl concentration (1.59%, the other for elevated pH (6.27 and both for high water activity values (>0.970]. The results of this research confirm that the cold resting step is a critical phase in the production process of Parma ham for the investigated hazard. Based on the present study, the long resting phase adopted in the manufacturing of Parma ham is proven effective to prevent the growth of C. botulinum, an event which could not otherwise be excluded if the hams were processed under less

  11. Use of botulinum toxin in musculoskeletal pain [v2; ref status: indexed, http://f1000r.es/16j

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    Jasvinder A Singh

    2013-07-01

    Full Text Available Chronic musculoskeletal pain is a common cause of chronic pain, which is associated with a total cost of $635 billion per year in the U.S. Emerging evidence suggests an anti-nociceptive action of botulinum toxin, independent of its muscle paralyzing action. This review provides a summary of data from both non-randomized and randomized clinical studies of botulinum toxin in back pain and various osteoarticular conditions, including osteoarthritis, tennis elbow, low back pain and hand pain. Three randomized controlled trials (RCTs of small sizes provide evidence of short-term efficacy of a single intra-articular injection of 100 units of botulinum toxin A (BoNT/A for the relief of pain and the improvement of both function and quality of life in patients with chronic joint pain due to arthritis. Three RCTs studied intramuscular BoNT/A for tennis elbow with one showing a significant improvement in pain relief compared with placebo, another one showing no difference from placebo, and the third finding that pain and function improvement with BoNT/A injection were similar to those obtained with surgical release. One RCT of intramuscular BoNT/A for low back pain found improvement in pain and function compared to placebo. Single RCTs using local injections of BoNT in patients with either temporomandibular joint (TMJ pain or plantar fasciitis found superior efficacy compared to placebo. One RCT of intramuscular BoNT/B in patients with hand pain and carpal tunnel syndrome found improvement in pain in both BoNT/B and placebo groups, but no significant difference between groups. Most evidence is based on small studies, but the use of BoNT is supported by a single, and sometimes up to three, RCTs for several chronic musculoskeletal pain conditions. This indicates that botulinum toxin may be a promising potential new treatment for chronic refractory musculoskeletal pain. Well-designed large clinical trials are needed.

  12. A comparative assessment of three formulations of botulinum toxin A for facial rhytides: a systematic review and meta-analyses

    OpenAIRE

    Bonaparte, James P; Ellis, David; Quinn, Jason G.; Ansari, Mohammed T.; Rabski, Jessica; Kilty, Shaun J

    2013-01-01

    Background Botulinum toxin A is a commonly used biological medication in the field of facial plastic surgery. Currently, there are three distinct formulations of botulinum toxin A, each with their purported benefits and advantages. However, there is considerable confusion as to the relative efficacy and side-effects associated with each formulation. Therefore, the purpose of this paper is to systematically assess published studies and perform a meta-analysis to determine if there is a signifi...

  13. Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective

    OpenAIRE

    José M. Climent; Ta-Shen Kuan; Pedro Fenollosa; Francisco Martin-del-Rosario

    2013-01-01

    Introduction. Botulinum toxin inhibits acetylcholine (ACh) release and probably blocks some nociceptive neurotransmitters. It has been suggested that the development of myofascial trigger points (MTrP) is related to an excess release of ACh to increase the number of sensitized nociceptors. Although the use of botulinum toxin to treat myofascial pain syndrome (MPS) has been investigated in many clinical trials, the results are contradictory. The objective of this paper is to identify sources o...

  14. Characterisation of botulinum toxins type C, D, E, and F by matrix-assisted laser desorption ionisation and electrospray mass spectrometry

    NARCIS (Netherlands)

    Baar, B.L.M. van; Hulst, A.G.; Jong, A.L. de; Wils, E.R.J.

    2004-01-01

    In a follow-up of the earlier characterisation of botulinum toxins type A and B (BTxA and BTxB) by mass spectrometry (MS), types C, D, E, and F (BTxC, BTxD, BTxE, BTxF) were now investigated. Botulinum toxins are extremely neurotoxic bacterial toxins, likely to be used as biological warfare agent. B

  15. Antibody-induced secondary treatment failure in a patient treated with botulinum toxin type A for glabellar frown lines

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    Stengel G

    2011-11-01

    Full Text Available Gabriele Stengel, Eva Kristina Bee Hautarztpraxis Stengel and Bee, Münster, Germany Abstract: Botulinum toxin type A (BTX-A preparations are widely used nonsurgical treatments for facial wrinkles. Higher doses of BTX-A are also used for therapeutic purposes in the treatment of conditions involving increased muscle tone, such as cervical dystonia. The phenomenon of antibody-induced treatment failure is well known in the therapeutic setting, but reports are also emerging following cosmetic use of BTX-A. We describe the case of a 41-year-old female nurse who developed secondary treatment failure during 6 years of BTX-A treatment for glabellar lines. After a good response to the first BTX-A injection, the intensity and duration of effect decreased after subsequent treatments. Antibody tests revealed a high titer of neutralizing anti-BTX-A antibodies. This case shows secondary treatment failure due to the production of neutralizing antibodies following administration of BTX-A formulations for cosmetic purposes and demonstrates that immunogenicity of BTX-A preparations is an important consideration, even in the cosmetic setting. Keywords: botulinum toxin type A, neutralizing antibodies, antibody-induced treatment failure

  16. Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain.

    Science.gov (United States)

    Moon, Young Eun; Choi, Jung Hyun; Park, Hue Jung; Park, Ji Hye; Kim, Ji Hyun

    2016-01-01

    Neuropathic pain includes postherpetic neuralgia (PHN), painful diabetic neuropathy (PDN), and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A) has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX(®), Allergan Inc., Irvine, CA, USA) into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4-5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief. PMID:26761032

  17. Ultrasound-Guided Nerve Block with Botulinum Toxin Type A for Intractable Neuropathic Pain

    Directory of Open Access Journals (Sweden)

    Young Eun Moon

    2016-01-01

    Full Text Available Neuropathic pain includes postherpetic neuralgia (PHN, painful diabetic neuropathy (PDN, and trigeminal neuralgia, and so on. Although various drugs have been tried to treat neuropathic pain, the effectiveness of the drugs sometimes may be limited for chronic intractable neuropathic pain, especially when they cannot be used at an adequate dose, due to undesirable severe side effects and the underlying disease itself. Botulinum toxin type A (BoNT-A has been known for its analgesic effect in various pain conditions. Nevertheless, there are no data of nerve block in PHN and PDN. Here, we report two patients successfully treated with ultrasound-guided peripheral nerve block using BoNT-A for intractable PHN and PDN. One patient had PHN on the left upper extremity and the other patient had PDN on a lower extremity. Due to side effects of drugs, escalation of the drug dose could not be made. We injected 50 Botox units (BOTOX®, Allergan Inc., Irvine, CA, USA into brachial plexus and lumbar plexus, respectively, under ultrasound. Their pain was significantly decreased for about 4–5 months. Ultrasound-guided nerve block with BoNT-A may be an effective analgesic modality in a chronic intractable neuropathic pain especially when conventional treatment failed to achieve adequate pain relief.

  18. A Monoclonal Antibody Based Capture ELISA for Botulinum Neurotoxin Serotype B: Toxin Detection in Food

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    Larry H. Stanker

    2013-11-01

    Full Text Available Botulism is a serious foodborne neuroparalytic disease, caused by botulinum neurotoxin (BoNT, produced by the anaerobic bacterium Clostridium botulinum. Seven toxin serotypes (A–H have been described. The majority of human cases of botulism are caused by serotypes A and B followed by E and F. We report here a group of serotype B specific monoclonal antibodies (mAbs capable of binding toxin under physiological conditions. Thus, they serve as capture antibodies for a sandwich (capture ELISA. The antibodies were generated using recombinant peptide fragments corresponding to the receptor-binding domain of the toxin heavy chain as immunogen. Their binding properties suggest that they bind a complex epitope with dissociation constants (KD’s for individual antibodies ranging from 10 to 48 × 10−11 M. Assay performance for all possible combinations of capture-detector antibody pairs was evaluated and the antibody pair resulting in the lowest level of detection (L.O.D., ~20 pg/mL was determined. Toxin was detected in spiked dairy samples with good recoveries at concentrations as low as 0.5 pg/mL and in ground beef samples at levels as low as 2 ng/g. Thus, the sandwich ELISA described here uses mAb for both the capture and detector antibodies (binding different epitopes on the toxin molecule and readily detects toxin in those food samples tested.

  19. Antinociceptive Effects of Botulinum Toxin Type A on Trigeminal Neuropathic Pain.

    Science.gov (United States)

    Yang, K Y; Kim, M J; Ju, J S; Park, S K; Lee, C G; Kim, S T; Bae, Y C; Ahn, D K

    2016-09-01

    Previous studies have demonstrated that botulinum toxin type A (BoNT-A) attenuates orofacial nociception. However, there has been no evidence of the participation of the voltage-gated sodium channels (Navs) in the antinociceptive mechanisms of BoNT-A. This study investigated the cellular mechanisms underlying the antinociceptive effects of BoNT-A in a male Sprague-Dawley rat model of trigeminal neuropathic pain produced by malpositioned dental implants. The left mandibular second molar was extracted under anesthesia, followed by a miniature dental implant placement to induce injury to the inferior alveolar nerve. Mechanical allodynia was monitored after subcutaneous injection of BoNT-A at 3, 7, or 12 d after malpositioned dental implant surgery. Subcutaneous injections of 1 or 3 U/kg of BoNT-A on postoperative day 3 significantly attenuated mechanical allodynia, although 0.3 U/kg of BoNT-A did not affect the air-puff threshold. A single injection of 3 U/kg of BoNT-A produced prolonged antiallodynic effects over the entire experimental period. Treatment with BoNT-A on postoperative days 7 and 12, when pain had already been established, also produced prolonged antiallodynic effects. Double treatments with 1 U/kg of BoNT-A produced prolonged, more antiallodynic effects as compared with single treatments. Subcutaneous administration of 3 U/kg of BoNT-A significantly inhibited the upregulation of Nav isoform 1.7 (Nav1.7) expression in the trigeminal ganglion in the nerve-injured animals. These results suggest that antinociceptive effects of BoNT-A are mediated by an inhibition of upregulated Nav1.7 expression in the trigeminal ganglion. BoNT-A is therefore a potential new therapeutic agent for chronic pain control, including neuropathic pain. PMID:27418174

  20. Best Clinical Practice in Botulinum Toxin Treatment for Children with Cerebral Palsy

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    Walter Strobl

    2015-05-01

    Full Text Available Botulinum toxin A (BoNT-A is considered a safe and effective therapy for children with cerebral palsy (CP, especially in the hands of experienced injectors and for the majority of children. Recently, some risks have been noted for children with Gross Motor Classification Scale (GMFCS of IV and the risks are substantial for level V. Recommendations for treatment with BoNT-A have been published since 1993, with continuous optimisation and development of new treatment concepts. This leads to modifications in the clinical decision making process, indications, injection techniques, assessments, and evaluations. This article summarises the state of the art of BoNT-A treatment in children with CP, based mainly on the literature and expert opinions by an international paediatric orthopaedic user group. BoNT-A is an important part of multimodal management, to support motor development and improve function when the targeted management of spasticity in specific muscle groups is clinically indicated. Individualised assessment and treatment are essential, and should be part of an integrated approach chosen to support the achievement of motor milestones. To this end, goals should be set for both the long term and for each injection cycle. The correct choice of target muscles is also important; not all spastic muscles need to be injected. A more focused approach needs to be established to improve function and motor development, and to prevent adverse compensations and contractures. Furthermore, the timeline of BoNT-A treatment extends from infancy to adulthood, and treatment should take into account the change in indications with age.

  1. Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins

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    Bahman Jabbari

    2013-04-01

    Full Text Available Clinical features, anatomy and physiology of hyperhidrosis are presented with a review of the world literature on treatment. Level of drug efficacy is defined according to the guidelines of the American Academy of Neurology. Topical agents (glycopyrrolate and methylsulfate are evidence level B (probably effective. Oral agents (oxybutynin and methantheline bromide are also level B. In a total of 831 patients, 1 class I and 2 class II blinded studies showed level B efficacy of OnabotulinumtoxinA (A/Ona, while 1 class I and 1 class II study also demonstrated level B efficacy of AbobotulinumtoxinA (A/Abo in axillary hyperhidrosis (AH, collectively depicting Level A evidence (established for botulinumtoxinA (BoNT-A. In a comparator study, A/Ona and A/Inco toxins demonstrated comparable efficacy in AH. For IncobotulinumtoxinA (A/Inco no placebo controlled studies exist; thus, efficacy is Level C (possibly effective based solely on the aforementioned class II comparator study. For RimabotulinumtoxinB (B/Rima, one class III study has suggested Level U efficacy (insufficient data. In palmar hyperhidrosis (PH, there are 3 class II studies for A/Ona and 2 for A/Abo (individually and collectively level B for BoNT-A and no blinded study for A/Inco (level U. For B/Rima the level of evidence is C (possibly effective based on 1 class II study. Botulinum toxins (BoNT provide a long lasting effect of 3–9 months after one injection session. Studies on BoNT-A iontophoresis are emerging (2 class II studies; level B; however, data on duration and frequency of application is inconsistent.

  2. Botulinum Toxin Treatment of Autonomic Disorders: Focal Hyperhidrosis and Sialorrhea.

    Science.gov (United States)

    Hosp, Christine; Naumann, Markus K; Hamm, Henning

    2016-02-01

    Primary focal hyperhidrosis is a common autonomic disorder that significantly impacts quality of life. It is characterized by excessive sweating confined to circumscribed areas, such as the axillae, palms, soles, and face. Less frequent types of focal hyperhidrosis secondary to underlying causes include gustatory sweating in Frey's syndrome and compensatory sweating in Ross' syndrome and after sympathectomy. Approval of onabotulinumtoxinA for severe primary axillary hyperhidrosis in 2004 has revolutionized the treatment of this indication. Meanwhile further type A botulinum neurotoxins like abobotulinumtoxinA and incobotulinumtoxinA, as well as the type B botulinum neurotoxin rimabotulinumtoxinB are successfully used off-label for axillary and various other types of focal hyperhidrosis. For unexplained reasons, the duration of effect differs considerably at different sites. Beside hyperhidrosis, botulinum neurotoxin is also highly valued for the treatment of sialorrhea affecting patients with Parkinson's disease, cerebral palsy, amyotrophic lateral sclerosis, motor neuron disease, and other neurologic conditions. With correct dosing and application, side effects are manageable and transient. PMID:26866492

  3. Botulinum Toxin Treatment of Autonomic Disorders: Focal Hyperhidrosis and Sialorrhea.

    Science.gov (United States)

    Hosp, Christine; Naumann, Markus K; Hamm, Henning

    2016-02-01

    Primary focal hyperhidrosis is a common autonomic disorder that significantly impacts quality of life. It is characterized by excessive sweating confined to circumscribed areas, such as the axillae, palms, soles, and face. Less frequent types of focal hyperhidrosis secondary to underlying causes include gustatory sweating in Frey's syndrome and compensatory sweating in Ross' syndrome and after sympathectomy. Approval of onabotulinumtoxinA for severe primary axillary hyperhidrosis in 2004 has revolutionized the treatment of this indication. Meanwhile further type A botulinum neurotoxins like abobotulinumtoxinA and incobotulinumtoxinA, as well as the type B botulinum neurotoxin rimabotulinumtoxinB are successfully used off-label for axillary and various other types of focal hyperhidrosis. For unexplained reasons, the duration of effect differs considerably at different sites. Beside hyperhidrosis, botulinum neurotoxin is also highly valued for the treatment of sialorrhea affecting patients with Parkinson's disease, cerebral palsy, amyotrophic lateral sclerosis, motor neuron disease, and other neurologic conditions. With correct dosing and application, side effects are manageable and transient.

  4. The use of botulinum toxin in head and face medicine: An interdisciplinary field

    Directory of Open Access Journals (Sweden)

    Laskawi Rainer

    2008-03-01

    Full Text Available Abstract Background In this review article different interdisciplinary relevant applications of botulinum toxin type A (BTA in the head and face region are demonstrated. Patients with head and face disorders of different etiology often suffer from disorders concerning their musculature (example: synkinesis in mimic muscles or gland-secretion. This leads to many problems and reduces their quality of life. The application of BTA can improve movement disorders like blepharospasm, hemifacial spasm, synkinesis following defective healing of the facial nerve, palatal tremor, severe bruxism, oromandibular dystonias hypertrophy of the masseter muscle and disorders of the autonomous nerve system like hypersalivation, hyperlacrimation, pathological sweating and intrinsic rhinitis. Conclusion The application of botulinum toxin type A is a helpful and minimally invasive treatment option to improve the quality of life in patients with head and face disorders of different quality and etiology. Side effects are rare.

  5. Comparação entre os métodos de injeção de toxina botulínica em músculo ocular externo com o uso do eletromiógrafo e com o uso da pinça de Mendonça Electromyograph assistance and Mendonça's forceps - a comparison between two methods of botulinum toxin A injection into the extraocular muscle

    Directory of Open Access Journals (Sweden)

    Tomás Fernando Scalamandré Mendonça

    2005-04-01

    Full Text Available OBJETIVO: Comparar dois métodos de aplicação de toxina botulínica A (TBA em músculo ocular externo: com auxílio de eletromiógrafo (EMG e com a pinça de Mendonça. MÉTODOS: Foram analisados no Departamento de Oftalmologia da UNIFESP 29 pacientes que apresentavam estrabismo e baixa acuidade visual em um olho. Foram divididos em dois grupos: grupo I - 17 pacientes que receberam a toxina botulínica A por meio de injeção com auxílio da pinça de Mendonça e grupo II - 12 pacientes que receberam a toxina botulínica A por injeção guiada pelo eletromiógrafo. Os pacientes dos dois grupos foram avaliados no 7º e no 14º dia após aplicação. Compararam-se os resultados dos dois grupos neste período de tempo. Os testes de correlação de Friedman e Mann-Whitney foram usados para análise estatística. RESULTADOS: Houve diferença estatística entre as médias de desvio pré-aplicação e em pelo menos um período (7º ou 14º dia após aplicação, tanto no grupo dos pacientes em que foi utilizada a pinça, quanto no grupo de pacientes em que foi utilizado o eletromiógrafo. Não houve diferença estatística dos desvios pré-aplicação e pós-aplicação entre os dois grupos. CONCLUSÃO: Os dois métodos de aplicação da toxina botulínica A são equivalentes e portanto, o uso da pinça de Mendonça pode ser método alternativo ao uso do eletromiógrafo, para guiar a injeção de toxina botulínica A.PURPOSE: To compare two methods of botulinum toxin A (BTA injection into the extraocular muscle (EOM: the electromyographically (EMG guided injection and the injection using Mendonça's forceps. METHODS: Twenty-nine (29 patients with strabismus and low visual acuity in one eye were examined at the Department of Ophthalmology of UNIFESP. They were divided into 2 groups - group I with 17 patients receiving the botulinum toxin A injection using Mendonça's forceps, and group II with 12 patients receiving the toxin with electromyographical

  6. Botulinum Toxin Treatment of Blepharospasm, Orofacial/Oromandibular Dystonia, and Hemifacial Spasm.

    Science.gov (United States)

    Karp, Barbara Illowsky; Alter, Katharine

    2016-02-01

    Blepharospasm is a focal dystonia characterized by involuntary, repetitive eye closure. Orofacial and oromandibular dystonia describe involuntary dystonic movements of orofacial and oromandibular musculature. Hemifacial spasm is characterized by repetitive synchronous contraction of facial nerve innervated muscles on one side of the face. In this article, the clinical presentation, epidemiology, and approaches to treatment are reviewed. Technical aspects of using botulinum toxin for treatment and reported outcomes are discussed.

  7. Association of toxin-producing Clostridium botulinum with the macroalga Cladophora in the Great Lakes.

    Science.gov (United States)

    Chun, Chan Lan; Ochsner, Urs; Byappanahalli, Muruleedhara N; Whitman, Richard L; Tepp, William H; Lin, Guangyun; Johnson, Eric A; Peller, Julie; Sadowsky, Michael J

    2013-03-19

    Avian botulism, a paralytic disease of birds, often occurs on a yearly cycle and is increasingly becoming more common in the Great Lakes. Outbreaks are caused by bird ingestion of neurotoxins produced by Clostridium botulinum, a spore-forming, gram-positive, anaerobe. The nuisance, macrophytic, green alga Cladophora (Chlorophyta; mostly Cladophora glomerata L.) is a potential habitat for the growth of C. botulinum. A high incidence of botulism in shoreline birds at Sleeping Bear Dunes National Lakeshore (SLBE) in Lake Michigan coincides with increasingly massive accumulations of Cladophora in nearshore waters. In this study, free-floating algal mats were collected from SLBE and other shorelines of the Great Lakes between June and October 2011. The abundance of C. botulinum in algal mats was quantified and the type of botulism neurotoxin (bont) genes associated with this organism were determined by using most-probable-number PCR (MPN-PCR) and five distinct bont gene-specific primers (A, B, C, E, and F). The MPN-PCR results showed that 16 of 22 (73%) algal mats from the SLBE and 23 of 31(74%) algal mats from other shorelines of the Great Lakes contained the bont type E (bont/E) gene. C. botulinum was present up to 15000 MPN per gram dried algae based on gene copies of bont/E. In addition, genes for bont/A and bont/B, which are commonly associated with human diseases, were detected in a few algal samples. Moreover, C. botulinum was present as vegetative cells rather than as dormant spores in Cladophora mats. Mouse toxin assays done using supernatants from enrichment of Cladophora containing high densities of C. botulinum (>1000 MPN/g dried algae) showed that Cladophora-borne C. botulinum were toxin-producing species (BoNT/E). Our results indicate that Cladophora provides a habitat for C. botulinum, warranting additional studies to better understand the relationship between this bacterium and the alga, and how this interaction potentially contributes to botulism

  8. Association of toxin-producing Clostridium botulinum with the macroalga Cladophora in the Great Lakes

    Science.gov (United States)

    Chun, Chan Lan; Ochsner, Urs; Byappanahalli, Muruleedhara N.; Whitman, Richard L.; Tepp, William H.; Lin, Guangyun; Johnson, Eric A.; Peller, Julie; Sadowsky, Michael J.

    2013-01-01

    Avian botulism, a paralytic disease of birds, often occurs on a yearly cycle and is increasingly becoming more common in the Great Lakes. Outbreaks are caused by bird ingestion of neurotoxins produced by Clostridium botulinum, a spore-forming, gram-positive, anaerobe. The nuisance, macrophytic, green alga Cladophora (Chlorophyta; mostly Cladophora glomerata L.) is a potential habitat for the growth of C. botulinum. A high incidence of botulism in shoreline birds at Sleeping Bear Dunes National Lakeshore (SLBE) in Lake Michigan coincides with increasingly massive accumulations of Cladophora in nearshore waters. In this study, free-floating algal mats were collected from SLBE and other shorelines of the Great Lakes between June and October 2011. The abundance of C. botulinum in algal mats was quantified and the type of botulism neurotoxin (bont) genes associated with this organism were determined by using most-probable-number PCR (MPN-PCR) and five distinct bont gene-specific primers (A, B, C, E, and F). The MPN-PCR results showed that 16 of 22 (73%) algal mats from the SLBE and 23 of 31(74%) algal mats from other shorelines of the Great Lakes contained the bont type E (bont/E) gene. C. botulinum was present up to 15 000 MPN per gram dried algae based on gene copies of bont/E. In addition, genes for bont/A and bont/B, which are commonly associated with human diseases, were detected in a few algal samples. Moreover, C. botulinum was present as vegetative cells rather than as dormant spores in Cladophora mats. Mouse toxin assays done using supernatants from enrichment of Cladophora containing high densities of C. botulinum (>1000 MPN/g dried algae) showed that Cladophora-borne C. botulinum were toxin-producing species (BoNT/E). Our results indicate that Cladophora provides a habitat for C. botulinum, warranting additional studies to better understand the relationship between this bacterium and the alga, and how this interaction potentially contributes to botulism

  9. Intravesical Botulinum Toxin for Persistent Autonomic Dysreflexia in a Pediatric Patient

    Directory of Open Access Journals (Sweden)

    Gina Lockwood

    2016-01-01

    Full Text Available Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin. Study Design. A retrospective chart review of one patient seen at the Children’s Hospital of Wisconsin from 2006 to 2012 was performed. Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months. Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient.

  10. Intravesical Botulinum Toxin for Persistent Autonomic Dysreflexia in a Pediatric Patient.

    Science.gov (United States)

    Lockwood, Gina; Durkee, Charles; Groth, Travis

    2016-01-01

    Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin. Study Design. A retrospective chart review of one patient seen at the Children's Hospital of Wisconsin from 2006 to 2012 was performed. Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months. Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient. PMID:27006855

  11. Studies on the irradiation of toxins of Clostridium botulinum and Staphylococcus aureus

    Energy Technology Data Exchange (ETDEWEB)

    Rose, S.A.; Bailey, N.E.; Stringer, M.F. (Campden Food and Drink Research Association, Chipping Campden (UK)); Modi, N.K.; Tranter, H.S. (Porton International plc., London (UK)); Hambleton, P. (Centre for Applied Microbiological Research, Porton Down (UK))

    1988-10-01

    The effects of irradiation of Clostridium botulinum neurotoxin type A (BNTA) and staphylococcal enterotoxin A (SEA) in gelatin phosphate buffer and cooked mince beef slurries were investigated. Estimation of toxins by immunoassays showed that in buffer, toxins were destroyed by irradiation at 8.0 kGy; in mince slurries however, 45% of BTNA and 27-34% of SEA remained after this level of irradiation. At 23.7 kGy, over twice the dose of irradiation proposed for legal acceptance in the UK, 15% of BNTA and 16-26% of SEA still remained. Increasing concentrations of mince conferred increased protection against the effect of irradiation on both toxins. The biological activity of BNTA was more sensitive to irradiation than the immunological activity. Staphylococcal enterotoxin was more resistant to irradiation than BNTA. Irradiation should therefore only be used in conjunction with good manufacturing practices to prevent microbial proliferation and toxin production prior to irradiation. (author).

  12. Studies on the irradiation of toxins of Clostridium botulinum and Staphylococcus aureus

    Energy Technology Data Exchange (ETDEWEB)

    Rose, S.A.; Bailey, N.E.; Stringer, M.F. (Campden Food and Drink Research Association, Chipping Campden (UK)); Modi, N.K.; Tranter, H.S. (Centre for Applied Micobiological Research, Porton Down, (UK)); Hambleton, P. (Porton International plc, London (UK))

    1989-09-01

    The effects of irradiation of Clostridium botulinum neutotoxin type A (BNTA) and staphylococcal enterotoxin A (SEA) in gelatin phosphate buffer and cooked mince beef slurries were investigated. Estimation of toxins by immunoassays showed that in buffer, toxins were destroyed by irradiation at 8.0 kGy; in mince slurries however, 45% of BTNA and 27-34% of SEA remained after this level of irradiation. At 23.7 kGy, over twice the dose of irradiation proposed for legal acceptance in the UK, 15% of BNTA and 16-26% of SEA still remained. Increasing concentrations of mince conferred increased protection against the effect of irradiation on both toxins. The biological activity of BNTA was more sensitive to irradiation than the immunological activity. Staphylococcal enterotoxin was more resistant to irradiation than BNTA. Irradiation should therefore only be used in conjunction with good manufacturing practices to prevent microbial proliferation and toxin production prior to irradiation. (author).

  13. Studies on the irradiation of toxins of Clostridium botulinum and Staphylococcus aureus

    International Nuclear Information System (INIS)

    The effects of irradiation of Clostridium botulinum neurotoxin type A (BNTA) and staphylococcal enterotoxin A (SEA) in gelatin phosphate buffer and cooked mince beef slurries were investigated. Estimation of toxins by immunoassays showed that in buffer, toxins were destroyed by irradiation at 8.0 kGy; in mince slurries however, 45% of BTNA and 27-34% of SEA remained after this level of irradiation. At 23.7 kGy, over twice the dose of irradiation proposed for legal acceptance in the UK, 15% of BNTA and 16-26% of SEA still remained. Increasing concentrations of mince conferred increased protection against the effect of irradiation on both toxins. The biological activity of BNTA was more sensitive to irradiation than the immunological activity. Staphylococcal enterotoxin was more resistant to irradiation than BNTA. Irradiation should therefore only be used in conjunction with good manufacturing practices to prevent microbial proliferation and toxin production prior to irradiation. (author)

  14. A型肉毒素治疗脑卒中康复患者肢体痉挛的护理体会%The Nursing Experience of Botulinum Toxin A in the Treatment of Limb Spasm for Stroke Rehabilitation Patients

    Institute of Scientific and Technical Information of China (English)

    王明霞; 尚小侠; 史盼

    2016-01-01

    目的:探讨A型肉毒素注射治疗肢体痉挛的护理。方法对我科31例脑卒中后肢体痉挛患者进行A型肉毒素注射治疗的临床护理进行回顾性分析。结果31例脑卒中后肢体痉挛患者经A型肉毒素注射治疗,配合适时护理,治疗后均获得良好效果,无严重并发症。结论对患者规范细致周到的护理有助于提高肉毒素注射疗效,减少并发症。%Objective To explore Nursing care of patients with limb spasm treated with botulinum toxin type A injection.Methods The clinical nursing of 31 patients with limb spasm after stroke in our department were retrospectively analyzed with the clinical nursing of A type botulinum toxin injection. Results31 cases of cerebral apoplexy patients with limb spasm were treated with botulinum toxin type A,with timely care,good results were obtained after treatment,no serious complications.Conclusion Careful and meticulous care of patients is helpful to impove the efficacy of botulinum toxin injection and reduce the complications.

  15. IGF-1 Antibody Prolongs the Effective Duration Time of Botulinum Toxin in Decreasing Muscle Strength

    Directory of Open Access Journals (Sweden)

    Yuguo Zheng

    2013-04-01

    Full Text Available Botulinum toxin type-A (Btx-A, a powerful therapeutic tool in various medical specialties, requires repeated injections to maintain its effect. Therefore, novel methods to prolong the effective duration time of Btx-A are highly needed. Rats were assigned to three major groups: control group (n = 30, Btx-A group (n = 30, and IGF-1 Ab groups. IGF-1 Ab groups were composed by sub-groups A1–A5 (each has 25 rats for the subsequent IGF-1Ab dose-effect study. Muscle strength was determined by a survey system for rat lower limbs nerve and muscle function. Muscle-specific receptor tyrosine kinase (MuSK, Insulin-like growth factor binding protein-5 (IGFBP5, and growth-associated protein, 43-kDa (GAP43 were determined by real-time polymerase chain reactions (PCRs and Western blot. We found that Btx-A decreased the muscle strength, with a paralysis maintained for 70 days. IGF-1Ab prolonged the effective duration time of Btx-A. Real-time PCRs and Western blot showed that IGF-1Ab delayed the increase of MuSK and IGFBP5 after Btx-A injection, without affecting GAP43. These results indicate that IGF-1Ab might prolong the effective duration time of Btx-A on muscle strength through delaying the increase of MuSK. It would be interesting to determine whether IGF-1Ab can be used as an auxiliary measure to the Btx-A treatment in the future.

  16. Botulinum Toxin A for Bladder Pain Syndrome/Interstitial Cystitis

    Science.gov (United States)

    Chiu, Bin; Tai, Huai-Ching; Chung, Shiu-Dong; Birder, Lori A.

    2016-01-01

    Botulinum neurotoxin A (BoNT-A), derived from Clostridium botulinum, has been used clinically for several diseases or syndrome including chronic migraine, spasticity, focal dystonia and other neuropathic pain. Chronic pelvic or bladder pain is the one of the core symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC). However, in the field of urology, chronic bladder or pelvic pain is often difficult to eradicate by oral medications or bladder instillation therapy. We are looking for new treatment modality to improve bladder pain or associated urinary symptoms such as frequency and urgency for patients with BPS/IC. Recent studies investigating the mechanism of the antinociceptive effects of BoNT A suggest that it can inhibit the release of peripheral neurotransmitters and inflammatory mediators from sensory nerves. In this review, we will examine the evidence supporting the use of BoNTs in bladder pain from basic science models and review the clinical studies on therapeutic applications of BoNT for BPS/IC. PMID:27376330

  17. [Toxin treatment of sweat pearls. A review of the treatment of hyperhidrosis with a special view of a new therapy option using botulinum toxin A].

    Science.gov (United States)

    Kreyden, O P; Burg, G

    2000-07-25

    Hyperhidrosis is defined as an excess of sweating beyond the amount needed to cool down elevated body temperature. We distinguish a primary and a secondary form, where an underlying endocrinological or neurological disease is found. The innervation of eccrine sweat glands is sympathetic but the transmitter is cholinergic (ACh). There are variable modalities in the treatment of focal hyperhidrosis, such as topical aluminium chloride application, tapwater iontophoresis, anticholinergic drugs or surgery (axillary sweat gland extraction, liposuction or thoracoscopic sympathectomy). Only recently botulinum toxin (BTX) has been introduced as a therapeutic tool for hyperhidrosis. As BTX inhibits the release of ACh at the cholinergic synapse, perspiration is arrested completely after intradermal injection. BTX is a very potent alternative to the surgical approach in the treatment of hyperhidrosis, though the treatment must be repeated regularly to maintain the effect. PMID:10971942

  18. The utility of EMG interference pattern analysis in botulinum toxin treatment of torticollis: a randomised, controlled and blinded study

    DEFF Research Database (Denmark)

    Werdelin, L; Dalager, T; Fuglsang-Frederiksen, Anders;

    2011-01-01

    OBJECTIVE: The significance of electromyography (EMG) guidance in botulinum toxin (BT) treatment has been much debated. The aim of this study was to evaluate if EMG guidance in the treatment of torticollis in BT-naive patients had a better outcome than treatment after clinical evaluation alone....... METHODS: Twenty-six patients with torticollis were included and treated for 1year in this prospective, blinded study. Quantitative EMG was performed simultaneously in the four most frequently affected muscles: the sternocleidomastoid muscles and the posterior neck muscles on both sides. EMGs were analysed...... for turns per second. Clinical ratings were performed by an experienced neurologist (A). Injections were given by another neurologist (B), who was blinded to the ratings. In group 1, the results of the EMG were available to the treating neurologist B, whereas in group 2, neurologist B was blinded. In group...

  19. Effects of botulinum toxin type A for spastic foot in post-stroke patients enrolled in a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-01-01

    Full Text Available The objective of this study was to evaluate the effects of botulinum toxin type A (BTX-A on spastic foot in stroke patients in a rehabilitation program. Method: Hemiparetic stroke patients (n=21 enrolled in a rehabilitation program were divided into two groups. The first group (n=11 received a total of 300UI BTX-A, and the second group (n=10 received 100 UI BTX-A. All patients were assessed at baseline and 2, 4, 8 and 12 weeks after injection for Modified Ashworth Score, time walking 10 meters, and the Functional Independence Measure (mFIM motor score. Results: The higher-dose group exhibited a significant improvement in spasticity, and both groups showed an improvement in time walking 10 meters and mFIM, with no significant differences between them. Conclusions: Our findings suggest that gains in gait velocity and functional independence were not correlated to BTX-A dose.

  20. Quantitative Effects on Proximal Joints of Botulinum Toxin Treatment for Gastrocnemius Spasticity: A 4-Year-Old Case Study

    Directory of Open Access Journals (Sweden)

    Veronica Cimolin

    2009-01-01

    Full Text Available Botulinum toxin A (BTA is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.

  1. Comparison between the effects of location by manual palpation and ultrasound guidance in botulinum toxin type A injection techniques for stroke patients' spastic equinovarus%超声引导和徒手肌肉定位法用于A型肉毒毒素治疗脑卒中患者痉挛性足下垂内翻的临床效果

    Institute of Scientific and Technical Information of China (English)

    欧海宁; 沈建虹; 陈红霞; 詹乐昌; 李梅

    2011-01-01

    Objective: To compare the clinical outcome of two different location techniques: manual palpation guidance and ultrasound guidance, for botulinum toxin type A injection into calf muscles in the treatment of spastic equinovarus in stroke patients.Method: Forty stroke patients with equinovarus were randomly assigned into two groups. All patients of both groups received injection of 300U botulinum toxin A in gastrocnemius, soleus and tibialis posterior muscles. The group A(n=18) was applied manual palpation-guided technique for location of injection. The group B(n=20) was applied ultrasound-guided technique for location of injection. Modified Ashworth scale(MAS), physician rating scale (PRS), speed of gait, passive range of motion(PROM) of ankle dorsiflexion and eversion were measured at baseline, and the 2nd, 4th, 8th, 12th week after treatment.Result: In each group, after treatment, the measurement indexes of MAS, gait pattern scale, speed of gait, PROM of ankle dorsiflexion and eversion all improved significantly(P<0.05). Group B improved significantly in MAS,PRS,speed of gait, PROM of ankle dorsiflexion and eversion at the 4th week(P<0.05), in MAS and PROM of ankle dorsiflexion at the 8th week(P<0.05), in MAS, speed of gait and PROM of ankle eversion at the 12th week comparing with group A(P<0.05). Comparing the trend of variations of measurement indexes during follow-up periods in two groups there was no statistical difference.Conclusion: The correction of equinovarus in stroke patients could be obtained by injecting botulinum toxin type A. Ultrasound-guided technique was considered to be a valid alternative technique for location of injection, which got superior clinical results than manual palpation-guided technique in some respects.%目的:比较超声引导下注射和徒手肌肉定位法在肉毒毒素注射治疗脑卒中患者足下垂内翻的临床效果.方法:46例符合纳人标准的脑卒中后足下垂内翻

  2. MOLECULAR-BIOLOGY OF CLOSTRIDIAL TOXINS - EXPRESSION OF MESSENGER-RNAS ENCODING TETANUS AND BOTULINUM NEUROTOXINS IN APLYSIA NEURONS

    NARCIS (Netherlands)

    MOCHIDA, S; POULAIN, B; EISEL, U; BINZ, T; KURAZONO, H; NIEMANN, H; TAUC, L

    1990-01-01

    mRNAs encoding the light chain of tetanus and botulinum neurotoxins were transcribed, in vitro, from the cloned and specifically truncated genes of Clostridium tetani and Clostridium botulinum, respectively, and injected into presynaptic identified cholinergic neurons of the buccal ganglia of Aplysi

  3. Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

    Directory of Open Access Journals (Sweden)

    Svetel Marina

    2007-01-01

    Full Text Available Background/Aim. Spasmodic dysphonia (DS is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80−100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12−16 units each. In our study we applied indirect technique originally developed by Hočevar and Pirtošek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index − (VHI that was rated as rather significant one (t = 3.562; p = 0.006. Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

  4. Renewable Surface Fluorescence Sandwich Immunoassay Biosensor for Rapid Sensitive Botulinum Toxin Detection in an Automated Fluidic Format

    Energy Technology Data Exchange (ETDEWEB)

    Grate, Jay W.; Warner, Marvin G.; Ozanich, Richard M.; Miller, Keith D.; Colburn, Heather A.; Dockendorff, Brian P.; Antolick, Kathryn C.; Anheier, Norman C.; Lind, Michael A.; Lou, Jianlong; Marks, James D.; Bruckner-Lea, Cindy J.

    2009-03-05

    A renewable surface biosensor for rapid detection of botulinum toxin is described based on fluidic automation of a fluorescence sandwich immunoassay, using a recombinant fragment of the toxin heavy chain as a structurally valid simulant. Monoclonal antibodies AR4 and RAZ1 bind to separate epitopes of both this fragment and the holotoxin. The AR4 antibody was covalently bound to Sepharose beads and used as the capture antibody. A rotating rod flow cell was used to capture these beads delivered as a suspension by the sequential injection flow system, creating a 3.6 microliter column. After perfusing the bead column with sample and washing away the matrix, the column was perfused with Alexa 647 dye-labeled RAZ1 antibody as the reporter. Optical fibers coupled to the rotating rod flow cell at a 90 degree angle to one another delivered excitation light from a HeNe laser and collected fluorescent emission light for detection. After each measurement, the used sepharose beads are released and replaced with fresh beads. In a rapid screening approach to sample analysis, the toxin simulant was detected to concentrations of 10 pM in less than 20 minutes.

  5. Beneficial effect of botulinum toxin A on Raynaud's phenomenon in Japanese patients with systemic sclerosis: A prospective, case series study.

    Science.gov (United States)

    Motegi, Sei-ichiro; Yamada, Kazuya; Toki, Sayaka; Uchiyama, Akihiko; Kubota, Yuka; Nakamura, Tetsuya; Ishikawa, Osamu

    2016-01-01

    Currently, there is no satisfactory treatment for Raynaud's phenomenon (RP) in systemic sclerosis (SSc). Recently, it has been reported that botulinum toxin A (BTX-A) injection was effective for the treatment of RP in SSc patients. The objective was to assess the efficacy and safety of BTX-A on RP in Japanese SSc patients. In the prospective, case series study, 10 Japanese SSc patients with RP received 10 U of BTX-A injections into the hand. The change in severity of RP, including the frequency of attacks/pain, color changes, duration time of RP and the severity of pain, was assessed by Raynaud's score and pain visual analog scale (VAS) at each visit during 16 weeks. The recovery of skin temperature 20 min after cold water stimulation was examined by thermography at baseline and 4 weeks after injection. The number of digital ulcers (DU) and adverse effects were assessed at each visit. BTX-A injection decreased Raynaud's score and pain VAS from 2 weeks after injection, and the suppressive effect was continued until 16 weeks after injection. Skin temperature recovery after cold water stimulation at 4 weeks after injection was significantly enhanced compared with that before injection. All DU in five patients were healed within 12 weeks after injection. Neither systemic nor local adverse effects were observed in all cases. We conclude that BTX-A injection significantly improved the activity of RP in SSc patients without any adverse events, suggesting that BTX-A may have possible long-term preventive and therapeutic potentials for RP in Japanese SSc patients.

  6. The Antigenicity Analysis of Botulinum Toxin of Clostridium botulinum Type C%C型肉毒梭菌肉毒毒素的抗原性分析

    Institute of Scientific and Technical Information of China (English)

    王娟娟; 刘书东; 李剑; 刘志龙; 陈根元; 曹玉华; 李莲瑞

    2012-01-01

    [目的]通过对分离纯化的C型肉毒毒素抗原性分析,提供快速鉴定动物因C型肉毒梭菌中毒的理论基础.[方法]对分离纯化的C型肉毒梭菌的肉毒毒素灭活后通过SDS - PAGE测定浓度,确定浓度后与弗氏佐剂乳化后免疫家兔,免疫结束后采家兔血液并分离血清.[结果]将不同稀释倍数的肉毒毒素经SDS -PAGE电泳分离后,转移至HybondNC膜,家兔三免后提取的血清作为一抗,用二抗进行Western blotting检测,大约在98.0和53.0 kDa处出现特异反应带;抗原与抗体在琼脂凝胶上结合时,会形成清晰的沉淀带.[结论]分离纯化的C型肉毒毒素,经免疫后家兔可见:C型肉毒毒素具有免疫原性和反应原性,抗体的效价为1∶8.%[Objective ] The study aims to provide the theoretical basis for quick identification of Clostridium botulinum type C through the separation and purification of type C botulinum toxin antigenic analysis. [ Method ] The experiments were carried out by separating and purifyinng Clostridium botulinum type C in the blood collected from Freunds adjuvant emulsified rabbit and the botulinum toxin was inactivated to determine the concentration by SDS - PAGE. The rabbit blood was collected after immunization and the serum was separated. [ Result ] Different dilutions of botulinum toxin were separated by SDS - PAGE electrophoresis, transferred to HybondNC film, and the three free extracted serum from rabbits was used as primary antibody. The secondary antibody was used for Western blotting analysis. At approximately 98.0 and 53.0 kDa, specific reaction zone appeared; antigens and antibodies in agar gel when combined will form a clear precipitation band. [Conclusion]The immunized rabbits, whose botulinum toxin type C was separated and purified by us, are still there. C botulinum toxin has the characteristics of immunogenicity and reactogenicity, and its antibody ti-ter is 1=8.

  7. Botox® after Botox® - a new approach to treat diplopia secondary to cosmetic botulinic toxin use: case reports

    Directory of Open Access Journals (Sweden)

    Cassiano Rodrigues Isaac

    2012-06-01

    Full Text Available A new technique for the treatment of diplopia secondary to cosmetic botulinum toxin A use is described. In this interventional case reports, two consecutive patients who developed diplopia after periocular cosmetic use of botulinum toxin A were treated with intramuscular botulinum toxin A injection into the antagonist extraocular muscle. Diplopia resolved in both patients in less than 1 week with no side effects or complications. In conclusion, the injection of intramuscular botulinum toxin A is an encouraging option for treatment of diplopia secondary to botulinum toxin A use for facial lifting.

  8. Efficacy of Botulinum toxin type A in treatment of different forms of focal dystonias in the Serbian population: Experience of the Botulinum Toxin Outpatients Department

    Directory of Open Access Journals (Sweden)

    Tomić Aleksandra

    2015-01-01

    Full Text Available Background/Aim. Botulinum toxin (BTX irreversibly inhibits presynaptic acetylcholine release with subsequent relaxation of abnormally contracting muscles. It is an effective and well tolerated treatment with long-term benefit in a variety of movement disorders and other neurological and non-neurological disturbances. The aim of our study was to present our experience with BTX type A in treatment of different forms of focal dystonias. Мethods. А hundred of patients with different focal dystonias (spastic torticollis, blepharospasm and graphospasm from the Botulinum Toxin Outpatients Department, Clinic for Neurology, Clinical Center of Serbia, were included in the study. All the patients were examined and rated at baseline visit prior to BTX application and on the following visit, after 3-4 months, using self-assessment improvement questionnaire and standardized rating scales. Results. The improvement of ≥ 50% was presented in 68.2% of all (199 the analyzed applications. Independent predictors of good response to the therapy (improvement ≥ 50% were male sex (p = 0.011, the presence of sensory trick (p = 0.013 and the total number of BTX applications (p = 0.002. The patients with spastic torticollis and blepharospasm showed a statistically significantly better BTX effect (improvement 57.3 ± 27.5% and 54.1 ± 28.3%, respectively than the graphospasm group (26.7 ± 25.6%. Most of the patients did not have therapy complications (81.4% and 72% in two applications. Side effects in the remaining patients (muscle weakness, dysphagia, ptosis, double vision, neck weakness and lacrimal dysfunction lasted for 28.3 ± 18.6 days after the first treatment and 32.5 ± 36.2 days after the second one. Conclusion. BTX is safe and highly effective in long-term treatment of patients with different forms of focal dystonia, with only mild and well-tolerated side-effects. [Projekat Ministarstva nauke Republike Srbije, br. 175090

  9. Effect of headspace CO2 concentration on toxin production by Clostridium botulinum in MAP, irradiated fresh pork

    International Nuclear Information System (INIS)

    The effects of five initial levels of CO2 (15, 30, 45, 60, and 75%) and three irradiation doses (0, 0.5, and 1.0 kGy) on toxin production by Clostridium botulinum in inoculated fresh pork were studied using factorial design experiments. Headspace CO2 levels increased in all samples during storage at 15 degrees C. In most treatments, spoilage preceded toxigenesis. Toxin production occurred faster in samples initially packaged with 15 to 30% of CO2 while higher levels of CO2 (45-75%) delayed toxin production. Low-dose irradiation delayed toxin production at all levels of CO2 in the package headspace. Contrary to expectations, including a CO2 absorbent in the package enhanced toxin production by C. botulinum. This was attributed to production of H2 by the CO2 absorbent, possibly resulting in a decrease in the oxido-reduction potential of the meat

  10. Treatment of severe drooling with botulinum toxin in amyotrophic lateral sclerosis and Parkinson's disease: Efficacy and possible mechanisms

    DEFF Research Database (Denmark)

    Møller, Eigild; Karlsborg, Merete; Jensen, Allan Bardow;

    2011-01-01

    Drooling in neurodegenerative diseases is associated with social impediment. Previous treatments of drooling have little effect or are effective but with severe side effects. Therefore, there is a need to test new methods such as the use of botulinum toxin type A (BTX-A).......Drooling in neurodegenerative diseases is associated with social impediment. Previous treatments of drooling have little effect or are effective but with severe side effects. Therefore, there is a need to test new methods such as the use of botulinum toxin type A (BTX-A)....

  11. Focal treatment of spasticity using botulinum toxin A in cerebral palsy cases of GMFCS level V: evaluation of adverse effects

    Directory of Open Access Journals (Sweden)

    Ana Paula Tedesco

    2014-08-01

    Full Text Available Objective:To report on the experience of injections of botulinum toxin A (BTA in a series of patients with cerebral palsy of Gross Motor Function Classification System (GMFCS level V.Methods:This was a retrospective case series study on 33 patients with cerebral palsy of GMFCS level V who received 89 sessions of BTA application (of which 84 were Botox® and five were other presentations, in which the basic aim was to look for adverse effects.Results:The mean number of application sessions per patient was three, and the mean age at the time of each injection was 4 + 6 years (range: 1.6–13 years. The muscles that most frequently received injections were the gastrocnemius, hamstrings, hip adductors, biceps brachii and finger flexors. The mean total dose was 193 U and the mean dose per weight was 12.5 U/kg. Only one patient received anesthesia for the injections and no sedation was used in any case. No local or systemic adverse effects were observed within the minimum follow-up of one month.Conclusion:The absence of adverse effects in our series was probably related to the use of low doses and absence of sedation or anesthesia. According to our data, BTA can be safely used for patients with cerebral palsy of GMFCS level V, using low doses and preferably without sedation or anesthesia.

  12. The Prediction of Botulinum Toxin Structure Based on in Silico and in Vitro Analysis

    Science.gov (United States)

    Suzuki, Tomonori; Miyazaki, Satoru

    2011-01-01

    Many of biological system mediated through protein-protein interactions. Knowledge of protein-protein complex structure is required for understanding the function. The determination of huge size and flexible protein-protein complex structure by experimental studies remains difficult, costly and five-consuming, therefore computational prediction of protein structures by homolog modeling and docking studies is valuable method. In addition, MD simulation is also one of the most powerful methods allowing to see the real dynamics of proteins. Here, we predict protein-protein complex structure of botulinum toxin to analyze its property. These bioinformatics methods are useful to report the relation between the flexibility of backbone structure and the activity.

  13. Botulinum toxin type A chemodenervation treatment in spastic forms of cerebral palsy

    OpenAIRE

    A. L. Kurenkov; S. S. Nikitin; A. R. Artemenko; B. I. Bursagova; Kuzenkova, L.M.; Petrova, S. A.; O. A. Klochkova; A. M. Mamedyarov

    2015-01-01

    Cerebral palsy (CP) is one of the most serious outcomes of the perinatal lesion of central nervous system and the most common reason for neurological disability in children. Being the key cause of pathological dynamic stereotypes that frequently result in pathological posture and contractures, spasticity is critically important for CP. The use of botulinum toxin type A (BTA) in complex treatment 2-6 years old CP patients allows significantly to improve motor abilities, help to change the surg...

  14. Botulinum toxin: An effective treatment for prosthesis-related hyperhidrosis in patients with traumatic amputations

    OpenAIRE

    Amanda Lezanski Gujda; Bingham, Jonathan L.; Logemann, Nicholas F

    2015-01-01

    Hyperhidrosis-related to prosthesis use in patients who have suffered a traumatic limb amputation presents itself as a barrier to comfort, prosthesis use and overall quality of life. This review intends to encourage dermatologists to consider the use of botulinum toxin A or B for the treatment of hyperhidrosis in the residual limb and may serve as a stimulus for a modern, in-depth, and more comprehensive study. A review of the literature was conducted using the PubMed database, focusing on hy...

  15. Focal hyperhidrosis secondary to eccrine naevus successfully treated with botulinum toxin type A.

    Science.gov (United States)

    Lera, M; España, A; Idoate, M Á

    2015-08-01

    Eccrine naevus (EN) is a rare skin hamartoma included in the organoid group of epidermal naevi, histologically defined as focal hyperplasia and/or hypertrophy of eccrine glands. Clinically, EN usually presents as hyperhidrotic patches with no visible skin changes, frequently located on the forearms. The decision to treat EN or not usually depends on the grade of hyperhidrosis, but there is no therapeutic consensus because of the rarity of this condition. We present a case diagnosed as EN in an adult patient with severe localized hyperhidrosis, which was successfully treated with botulinum toxin. PMID:25816711

  16. Role of Botulinum Toxin Type-A (BTX-A) in the Management of Trigeminal Neuralgia

    OpenAIRE

    Gaurav Verma

    2013-01-01

    Trigeminal neuralgia (TN) is a clinical condition characterized by paroxysmal attacks of severe and electric shock-like pain along the distribution of one or more branches of the trigeminal nerve. Various medicinal or surgical modalities have been employed in the past with variable success. Newer methods were tried in search of permanent cure or long-lasting pain relief. The purpose of this paper is to present the review of the literature regarding the use of botulinum toxin type-A (BTX-A) in...

  17. The use of botulinum toxin and epidural analgesia for the treatment of spasticity and pain in a patient with maple syrup urine disease

    Directory of Open Access Journals (Sweden)

    Abdullah M Kaki

    2012-01-01

    Full Text Available A 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUD. He suffered from spasticity of the lower limbs and pain that did not respond to oral medications. Injections of botulinum toxin A (BTX-A at 10 sites and epidural analgesia with 0.125% bupivacaine were used to treat spasticity with good results. We conclude that BTX-A combined with epidural analgesia may be a useful treatment option for incapacitating, painful spasticity related to MSUD. This treatment modality allowed a comprehensive rehabilitation program to be completed and it lasted longer than 9 months.

  18. Prevalence of toxin-producing Clostridium botulinum associated with the macroalga Cladophora in three Great Lakes: growth and management.

    Science.gov (United States)

    Lan Chun, Chan; Kahn, Chase I; Borchert, Andrew J; Byappanahalli, Muruleedhara N; Whitman, Richard L; Peller, Julie; Pier, Christina; Lin, Guangyun; Johnson, Eric A; Sadowsky, Michael J

    2015-04-01

    The reemergence of avian botulism caused by Clostridium botulinum type E has been observed across the Great Lakes in recent years. Evidence suggests an association between the nuisance algae, Cladophora spp., and C. botulinum in nearshore areas of the Great Lakes. However, the nature of the association between Cladophora and C. botulinum is not fully understood due, in part, to the complex food web interactions in this disease etiology. In this study, we extensively evaluated their association by quantitatively examining population size and serotypes of C. botulinum in algal mats collected from wide geographic areas in lakes Michigan, Ontario, and Erie in 2011-2012 and comparing them with frequencies in other matrices such as sand and water. A high prevalence (96%) of C. botulinum type E was observed in Cladophora mats collected from shorelines of the Great Lakes in 2012. Among the algae samples containing detectable C. botulinum, the population size of C. Botulinum type E was 10(0)-10(4) MPN/g dried algae, which was much greater (up to 10(3) fold) than that found in sand or the water column, indicating that Cladophora mats are sources of this pathogen. Mouse toxinantitoxin bioassays confirmed that the putative C. botulinum belonged to the type E serotype. Steam treatment was effective in reducing or eliminating C. botulinum type E viable cells in Cladophora mats, thereby breaking the potential transmission route of toxin up to the food chain. Consequently, our data suggest that steam treatment incorporated with a beach cleaning machine may be an effective treatment of Cladophora-borne C. botulinum and may reduce bird mortality and human health risks.

  19. Prevalence of toxin-producing Clostridium botulinum associated with the macroalga Cladophora in three Great Lakes: growth and management

    Science.gov (United States)

    Chun, Chan Lan; Kahn, Chase I.; Borchert, Andrew J.; Byappanahalli, Muruleedhara N.; Whitman, Richard L.; Peller, Julie R.; Pier, Christina; Lin, Guangyun; Johnson, Eric A.; Sadowsky, Michael J.

    2015-01-01

    The reemergence of avian botulism caused by Clostridium botulinum type E has been observed across the Great Lakes in recent years. Evidence suggests an association between the nuisance algae, Cladophoraspp., and C. botulinum in nearshore areas of the Great Lakes. However, the nature of the association between Cladophora and C. botulinum is not fully understood due, in part, to the complex food web interactions in this disease etiology. In this study, we extensively evaluated their association by quantitatively examining population size and serotypes of C. botulinum in algal mats collected from wide geographic areas in lakes Michigan, Ontario, and Erie in 2011–2012 and comparing them with frequencies in other matrices such as sand and water. A high prevalence (96%) of C. botulinum type E was observed inCladophora mats collected from shorelines of the Great Lakes in 2012. Among the algae samples containing detectable C. botulinum, the population size of C. Botulinum type E was 100–104 MPN/g dried algae, which was much greater (up to 103 fold) than that found in sand or the water column, indicating thatCladophora mats are sources of this pathogen. Mouse toxinantitoxin bioassays confirmed that the putativeC. botulinum belonged to the type E serotype. Steam treatment was effective in reducing or eliminating C. botulinum type E viable cells in Cladophora mats, thereby breaking the potential transmission route of toxin up to the food chain. Consequently, our data suggest that steam treatment incorporated with a beach cleaning machine may be an effective treatment of Cladophora-borne C. botulinum and may reduce bird mortality and human health risks.

  20. [Axillary hyperhidrosis, botulinium A toxin treatment: Review].

    Science.gov (United States)

    Clerico, C; Fernandez, J; Camuzard, O; Chignon-Sicard, B; Ihrai, T

    2016-02-01

    Injection of type A botulinum toxin in the armpits is a temporary treatment for axillary hyperhidrosis. This technique described in 1996 by Bushara et al., is known to be efficient and safe. The purpose of this article was to review the data concerning the treatment of axillary hyperhidrosis with botulinum toxin type A, and discuss the other treatment modalities for this socially disabling entity.

  1. Clinical Efficacy of Ultrasound-guided Botulinum Toxin Type A Injection and Muscle Electricity Biofeedback Treatment for Patients with Spasticity in Lower Limb Muscles%彩超引导下肉毒毒素注射和肌电生物反馈治疗下肢肌肉痉挛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈华先; 丁旭东; 张贵斌; 黄瓅; 宋金辉; 洪艳; 王汉

    2012-01-01

    Objective: To evaluate the clinical effect of ultrasound-guided botulinum toxin type A (BTX-A) injection and muscle electricity biofeedback treatment for patients with spastici-ty in the lower limb muscles after cerebral infarction. Methods: Thirty-six patients with lower limb muscle Spasms after cerebral infarction were randomly divided into control group and the treatment group with 18 cases in the each group. The ultrasound-guided BTX-A injection was applied to the both groups whereas muscle electricity biofeedback treatment was performed additional to those in the treatment group after 24 hours. The outcome was assessed by modified Ash-worth scale (MAS). Results: The recovery of Muscle spasms in the electricity biofeedback treatment group was better than that in the control group. Conclusion: The ultrasound guided BTX-A injection and muscle electricity biofeedback treatment are effective for treatingt patients with lower limb muscle spasticity after cerebral infarction.%目的:观察采用彩超引导下注射A型肉毒毒素(BTX-A)和肌电生物反馈治疗脑梗死后下肢肌肉痉挛的临床疗效.方法:选择36例脑梗死偏瘫后下肢肌肉痉挛患者,随机分成治疗组及对照组各18例.2组均对下肢痉挛肌群进行分点注射BTX-A,治疗组24 h后给予肌电生物反馈治疗6周,采用改良Ashworth评分(MAS)、步长、步速评估2组疗效.结果:治疗组治疗6周后MAS评分、步长、步速优于对照组(P<0.05).结论:采用彩超引导下多位点注射BTX-A结合肌电生物反馈治疗脑梗死后下肢肌肉痉挛有明显疗效.

  2. A型肉毒毒素注射配合康复功能训练对痉挛型偏瘫脑瘫患儿上肢运动功能疗效观察%Effect of Botulinum Toxin Type A Injection Combined with Rehabilitation Functional Training on Upper Extremity Motor Function in Children with Spastic Hemiplegic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    颜华; 张惠佳; 阳伟红; 王益梅; 郭春光; 胡继红; 周平秋; 何金华; 段华林

    2012-01-01

    目的 观察A型肉毒毒素(BTX-A)注射治疗配合康复功能训练对痉挛型偏瘫脑瘫患儿上肢功能障碍的疗效.方法 60例痉挛型偏瘫型脑瘫患儿均接受BTX-A注射治疗,治疗后进行强制性诱导运动训练、物理疗法、肌电生物反馈治疗、作业治疗及家庭训练.在治疗前与治疗3个月后,分别用改良Ashworth痉挛量表(MAS)评定患侧上肢肌张力、关节量角器法测量患侧腕关节主动背伸角度、Peabody运动发育量表(PDMS-II)进行患侧手精细运动商(FMQ)的评估、日常生活活动能力(ADL)量表评估ADL能力以比较观察疗效.结果 治疗后患儿上述指标均较治疗前显著改善(P<0.001).结论 BTX-A注射治疗配合康复功能训练能明显降低痉挛型偏瘫型脑瘫患儿的上肢肌张力,改善关节活动范围,明显提高上肢运动功能.%Objective To observe the effect of Botulinum toxin type A (BTX-A) injection combined with rehabilitation functional training on upper extremity motor function in children with spastic hemiplegic cerebral palsy (CP). Methods 60 spastic hemiplegic CP children were treated with constraint-induced movement therapy (CIMT), physical therapy, electromyographic biofeedback stimulation therapy, occupational therapy, family-based training and so on after injected with BTX-A. The muscle tension of the hemiplegic upper extremity accessed by Modified Ashworth Scale (MAS), the wrist angle of active dorsiextention motion by orthrometer, fine movement quotient (FMQ) by Pea-body developmental motor scale (PDMS- II), and activities of daily living (ADL) were performed to evaluate the effects before and 3 months after treatment. Results These outcomes were improved significantly after treatment (P<0.001). Conclusion BTX-A injection combined with rehabilitation functional training could rapidly reduce spasticity of the upper extremity, increase the range of motion, improve motor function of upper extremity in children with spastic

  3. Neutralizing Antibody and Botulinum Toxin Therapy: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Fabbri, Margherita; Leodori, Giorgio; Fernandes, Ricardo M; Bhidayasiri, Roongroj; Marti, Maria Jose; Colosimo, Carlo; Ferreira, Joaquim J

    2016-01-01

    The formation of neutralizing antibodies (NAbs) directed specifically against the active neurotoxin part of the botulinum neurotoxin (BoNT) complex is often cited as a major cause of secondary non-responsiveness (SnR) to treatment. This systematic and meta-analytic review evaluates the frequency of NAbs among patients treated with BoNT therapy for any clinical indication. A comprehensive database search strategy was designed to retrieve relevant clinical data from the published literature up to April 2013. All English-language publications that analyzed NAbs prevalence in more than ten patients were included, regardless of BoNT formulation, assay method, and study design. For the meta-analysis, patients were divided into three categories: secondary nonresponse (SnR) patients, clinically responding patients and all patients, independently of BoNT responsiveness. The meta-analysis included 61 studies reporting data for 8525 patients; 4972 dystonic patients, 1170 patients with spasticity, 294 patients with urologic indications, 396 patient with hyperhidrosis, 1659 patients with glabellar line, and 34 patients with hypersalivation. Among the ‘‘all patients’’ group NAbs frequency was 20%for dystonia, 5.9%for spasticity, and 2.7% for urologic patients and 1.1% for other conditions. The prevalence of NAbs was lower (3.5%) among clinically responding patients and higher in 53.5%SnR patients. About a half of patients with SnR do not have NAbs. NAbs was high among patients treated with RIMA but it was not associated with clinical non-responsiveness. Meta-analysis of the frequency of NAbs and SnR are limited by the heterogeneity of study design and reported outcomes. Indeed the analysis of several factors that can influence the development of NAbs, i.e.,MHCof patients, frequency and site of injection, injection technique, cumulative dose, and toxin denaturation, was not specifically evaluated due to the paucity and heterogeneity of data. The identification of all

  4. [Dose-response relationship in the treatment of cervical dystonia with botulinum toxin type A (AGN 191622)--a phase II study].

    Science.gov (United States)

    Mezaki, T; Kaji, R; Kimura, J; Mannen, T

    1995-09-01

    Injection of botulinum toxin type A has been the treatment of choice for spasmodic torticollis for several years. Although previous reports demonstrate its effectiveness and safety, the treatment strategy has been empirical. The present study, using the freeze-dried crystalline botulinum toxin type A (AGN 191622; Allergan Inc., Irvine, CA), aimed to compare the efficacy among three treatment groups divided into low, medium and high dosage levels. Fifty-one patients who entered the study were grouped into low-dose (60 units/session), medium-dose (120 units/session) and high-dose (240 units/session) groups. Two patients (one in low-dose group and the other in high-dose group) were excluded from the assessment of efficacy because they dropped out in the early phase of the study. One experienced worsening of an existing psychosis and the other developed an acute respiratory infection. Injection sites were decided individually by palpation. If the clinical response was not satisfactory four weeks after an injection, the patient was re-injected with the same dose of toxin. The follow-up period was 14 weeks from the initial injection. The results showed that the high-dose group improved more than the other groups in the parameters of severity of symptoms and subjective benefit (p = 0.000). Also, fewer injections were required in the high-dose group to achieve substantial clinical benefit. Although the mean reduction in Tsui's score was not statistically significant among the groups, the "marked improvement" was seen more frequently in the high-dose group (p = 0.033). Unfavorable adverse effects including excessive weakness and dysphasia were always mild and transient.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Botulinum Toxin Type A for Treatment of Facial Wrinkles%A型肉毒毒素用于面部除皱的护理

    Institute of Scientific and Technical Information of China (English)

    党艳茹; 卢宁; 刘玉琴; 李芊

    2014-01-01

    Objective:To explore the nursing effect of the face lift and injection of botulinum toxin A treatment,in order to improve the level and effect of facial wrinkles rhytidectomy. Method:The receiving and treatment of facial wrinkles randomness extraction in 166 cases from February,2010 to December,2013 in the hospital were analyzed retrospectively,including 150 women and 16 men. They were treated with botulinum toxin type A. The treatment effect and characteristics were analyzed. Result:After the use of botulinum toxin injection in the treatment of facial wrinkles,the effect is good,effective rate of the treatment of crow’s feet is 98%,the effective rate in treatment of forehead wrinkles is 100%,and the effective rate in treatment of wrinkles between brow is 96%. Conclusion:The facial wrinkles with botulinum toxin A injection for treatment has good effect and safety,which is under convenient operation. So it is worthy of application and popularization in facial wrinkle elimination.%目的:分析针对面部除皱采用A型肉毒毒素注射治疗的护理效果和特点,以提高面部除皱的效果。方法:从我院2010年2月至2013年12月收治的面部除皱患者中随机性抽取166例进行回顾性分析和研究,其中女性150例,男性有16例,均采用A型肉毒毒素注射治疗,分析治疗的效果和特点。结果:采用肉毒毒素注射治疗面部皱纹后,效果较好,鱼尾纹的治疗有效率为98%,额部皱纹的治疗有效率为100%,眉间皱纹的治疗有效率为96%。结论:针对面部皱纹采用注射A型肉毒毒素进行治疗,效果和安全性较好,操作方便,值得在面部皱纹消除中应用和推广。

  6. Toosendanin interferes with pore formation of botulinum toxin type A in PC12 cell membrane

    Institute of Scientific and Technical Information of China (English)

    Mu-feng LI; Yu-liang SHI

    2006-01-01

    Aim: Botulinum neurotoxins (BoNT) abort the process of neurotransmitter release at presynaptic motor nerve terminals, causing muscle paralysis. The ability of botulinum toxin to produce its effect is dependent on the ability of the light chain to cleave the SNARE proteins associated with transmitter release. Translocation of the light chain protease through the heavy chain-formed channel is a pivotal step in the intoxication process. Toosendanin (TSN), a triterpenoid derivative extracted from a Chinese traditional medicine, has been demonstrated to be an effective cure for experimental botulism. This study was designed to explore the antibotulismic mechanisms of toosendanin. Methods: The inside-out singlechannel recording patch-clamp technique was used to record the BoNT/A-induced currents in the presence and absence of TSN. Results: Channel formation was delayed and the sizes of the channels were reduced in the TSN-treated PC12cell membrane. Conclusion: The antibotulismic effect of TSN might occur via interference with toxin translocation.

  7. Attomolar detection of botulinum toxin type A in complex biological matrices.

    Directory of Open Access Journals (Sweden)

    Karine Bagramyan

    Full Text Available BACKGROUND: A highly sensitive, rapid and cost efficient method that can detect active botulinum neurotoxin (BoNT in complex biological samples such as foods or serum is desired in order to 1 counter the potential bioterrorist threat 2 enhance food safety 3 enable future pharmacokinetic studies in medical applications that utilize BoNTs. METHODOLOGY/PRINCIPAL FINDINGS: Here we describe a botulinum neurotoxin serotype A assay with a large immuno-sorbent surface area (BoNT/A ALISSA that captures a low number of toxin molecules and measures their intrinsic metalloprotease activity with a fluorogenic substrate. In direct comparison with the "gold standard" mouse bioassay, the ALISSA is four to five orders of magnitudes more sensitive and considerably faster. Our method reaches attomolar sensitivities in serum, milk, carrot juice, and in the diluent fluid used in the mouse assay. ALISSA has high specificity for the targeted type A toxin when tested against alternative proteases including other BoNT serotypes and trypsin, and it detects the holotoxin as well as the multi-protein complex form of BoNT/A. The assay was optimized for temperature, substrate concentration, size and volume proportions of the immuno-sorbent matrix, enrichment and reaction times. Finally, a kinetic model is presented that is consistent with the observed improvement in sensitivity. CONCLUSIONS/SIGNIFICANCE: The sensitivity, specificity, speed and simplicity of the BoNT ALISSA should make this method attractive for diagnostic, biodefense and pharmacological applications.

  8. Botulinum toxin for chronic anal fissure after biliopancreatic diversion for morbid obesity

    Institute of Scientific and Technical Information of China (English)

    Serafino Vanella; Giuseppe Brisinda; Gaia Marniga; Anna Crocco; Giuseppe Bianco; Giorgio Maria

    2012-01-01

    AIM:To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity.METHODS:Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study.The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment.All data were analyzed in univariate and multivariate analysis.RESULTS:Two months after treatment,65.4% of the patients had a healing scar.Only one patient had mild incontinence to flatus that lasted 3 wk after treatment,but this disappeared spontaneously.In the multivariate analysis of the data,two registered months after the treatment,sex (P =0.01),baseline resting anal pressure (P =0.02) and resting anal pressure 2 mo after treatment (P < 0.0001) were significantly related to healing rate.CONCLUSION:Botulinum toxin,despite worse results than in non-obese individuals,appears the best alternative to surgery for this group of patients with a high risk of incontinence.

  9. Botulinum toxin as treatment for focal dystonia : a systematic review of the pharmaco-therapeutic and pharmaco-economic value

    NARCIS (Netherlands)

    Zoons, E.; Dijkgraaf, M. G. W.; Dijk, J. M.; van Schaik, I. N.; Tijssen, M. A.

    2012-01-01

    Focal dystonia is a common, invalidating neurologic condition characterized by involuntary, sustained muscle contractions causing twisting movements and abnormal postures in one body part. Currently, botulinum toxin is the treatment of first choice. We performed a systematic review towards the pharm

  10. The Use of Botulinum Toxin for the Treatment of Muscle Spasticity in the First 2 Years of Life

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    Although there are sound theoretical reasons for the use of botulinum toxin (Btx) as early as possible in the management of severe childhood muscle spasticity, the experience with its safety in children younger than 2 years of age is limited and information about its possible effects on the development and maturation of the human motor system…

  11. A critical appraisal of the evidence for botulinum toxin type A in the treatment for cervico-thoracic myofascial pain syndrome.

    Science.gov (United States)

    Desai, Mehul J; Shkolnikova, Tatyana; Nava, Andrew; Inwald, Danielle

    2014-02-01

    Myofascial pain syndrome (MPS) is a musculoskeletal condition characterized by regional pain and muscle tenderness associated with the presence of myofascial trigger points (MTrPs). The last decade has seen an exponential increase in the use of botulinum toxin (BTX) to treat MPS. To understand the medical evidence substantiating the role of therapeutic BTX injections and to provide useful information for the medical practitioner, we applied the principles of evidence-based medicine to the treatment for cervico-thoracic MPS. A search was conducted through MEDLINE (PubMed, OVID, MDConsult), EMBASE, SCOPUS and the Cochrane database for the period 1966 to 2012 using the following keywords: myofascial pain, muscle pain, botulinum toxin, trigger points, and injections. A total of 7 trials satisfied our inclusion criteria and were evaluated in this review. Although the majority of studies found negative results, our analysis identified Gobel et al.'s as the highest quality study among these prospectively randomized investigations. This was due to appropriate identification of diagnostic criteria, excellent study design and objective endpoints. The 6 other identified studies had significant failings due to deficiencies in 1 or more major criteria. We conclude that higher quality, rigorously standardized studies are needed to more appropriately investigate this promising treatment modality.

  12. A preliminary study of painless and effective transdermal botulinum toxin A delivery by jet nebulization for treatment of primary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Iannitti T

    2014-07-01

    Full Text Available Tommaso Iannitti,1,2 Beniamino Palmieri,3 Anna Aspiro,3 Alessandro Di Cerbo2,3 1School of Biomedical Sciences, University of Leeds, Leeds, UK; 2Poliambulatorio del Secondo Parere, Modena, Italy; 3Department of Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy Background: Hyperhidrosis is a chronic disease characterized by increased sweat production. Local injections of botulinum toxin A (BTX-A have been extensively used for treatment of primary hyperhidrosis (idiopathic. The current treatment for this condition involves several intradermal injections, resulting in poor patient compliance due to injection-related pain. Therefore, new protocols, including an improved anesthetic regimen, are required. Aim: We designed the present study to determine whether JetPeel™-3, a medical device used for transdermal delivery of drugs by jet nebulization, could be used to deliver lidocaine prior to the standard multiple BTX-A injections or deliver lidocaine together with BTX-A in order to determine the protocol giving better results in terms of procedure-related pain, sweating, and patient satisfaction in subjects affected by primary axillary, palmar or plantar hyperhidrosis. Materials and methods: Twenty patients with a visual analog scale (VAS sweating score ≥ 8 cm were randomized to receive lidocaine 2% (5 mL delivered by JetPeel™-3 followed by multiple injections of BTX-A (100 units or lidocaine 2% (5 mL and BTX-A (50 units delivered together by JetPeel™-3. Effect of treatment on sweating was measured by VAS (0= minimum sweating; 10= maximum sweating at 3-month follow-up. Pain induced by the procedure was assessed by VAS (0= minimum pain; 10= maximum pain immediately after the procedure. Patient satisfaction was assessed at 3-month follow-up using a 5-point scale (1= not at all satisfied; 2= not satisfied; 3= partially satisfied; 4= satisfied; 5= highly satisfied. Results: Both

  13. Severity and impact of xerostomia in patients treated with botulinum toxin type b for cervical dystonia: Observations on the quality of life of patients with xerostomia

    OpenAIRE

    Hogan, Patrick; Charles, P. David; Wooten Watts, Maureen; Massey, Janice M.; Miller, Tamara; Mackowiack, John

    2004-01-01

    Background: Although dry mouth (xerostomia) has been reported with botulinum toxin type B used as treatment for cervical dystonia, the impact of this adverse effect (AE) on patients' activities of daily living (ADLs) has not been assessed.

  14. Análise estrutural da laringofaringe e suas implicações na miotomia do cricofaríngeo, na injeção de toxina botulínica e na dilatação por balão Laryngopharyngeal structural analysis and its morphofunctional correlation with cricopharyngeal myotomy, botulinum toxin injection and balloon dilation

    Directory of Open Access Journals (Sweden)

    Milton Melciades Barbosa Costa

    2003-06-01

    characteristics and relationships on 24 pieces obtained from adults' corpses of both sexes fixed in 10% formaldehyde solution. RESULTS: The cricopharyngeal muscle presenting its anterior-lateral insertion, with a C-shaped outline, on the posterior-lateral edge of the cricoid cartilage. This kind of morphology blocks the possibility to generate a predominant anterior and posterior high pressure during its contraction like that we find at the pharyngoesophageal transition. The observation of this kind of pressure has its explanation in a tweezers-like relationship exerted on one side by the vertebral body and on the other side by the posterior contour of the cricoid cartilage. CONCLUSIONS: The muscular organization of the laryngopharyngeal segment allowed us to sustain that a large myotomy of the pharyngoesophageal transition, that takes more than just the cricopharyngeal transversal fasciculus, hinders the ejection function in a region where the dimension do not need any parietal sectioning. Myotomy that encompasses only the transversal fasciculus can contribute to improve the pharyngoesophageal flux by a decrease of the local resistance. The efficiency of this myotomy depends mostly on some residual pharyngeal ejection force and also on a slight hyolaryngeal displacement. The transversal fasciculus of the cricopharyngeal muscle is a narrow strip of muscular mass to be injected by percutaneous way with solution of botulinum toxin; maybe endoscopically. For this reason, dose, dilution and injection sites have an important meaning in the cricopharyngeal therapeutics using botulinum toxin. The efficiency of this procedure, like myotomy, depends on some residual pharyngeal ejection force and on, at least, some hyolaryngeal displacement. The dilation of the pharyngoesophageal transition with pneumatic balloon does not seem to be an adequate procedure for a region that does not present a narrow lumen determined by fibrosis. For anatomical characteristics of the TFE region, mean pressure

  15. Botulinum toxin: An effective treatment for prosthesis-related hyperhidrosis in patients with traumatic amputations

    Directory of Open Access Journals (Sweden)

    Amanda Lezanski Gujda

    2015-01-01

    Full Text Available Hyperhidrosis-related to prosthesis use in patients who have suffered a traumatic limb amputation presents itself as a barrier to comfort, prosthesis use and overall quality of life. This review intends to encourage dermatologists to consider the use of botulinum toxin A or B for the treatment of hyperhidrosis in the residual limb and may serve as a stimulus for a modern, in-depth, and more comprehensive study. A review of the literature was conducted using the PubMed database, focusing on hyperhidrosis treatment after traumatic limb amputation. Articles discussing hyperhidrosis treatment for amputations secondary to chronic medical conditions were excluded. Seven case studies published over the last 12 years have demonstrated positive outcomes of this treatment strategy. Overall, there is little data examining this topic and current publications focus primarily on small case series. A larger, double-blind, placebo-controlled study would likely benefit veterans, service members, and civilians.

  16. Botulinum toxin: An effective treatment for prosthesis-related hyperhidrosis in patients with traumatic amputations.

    Science.gov (United States)

    Lezanski-Gujda, Amanda; Bingham, Jonathan L; Logemann, Nicholas F

    2015-01-01

    Hyperhidrosis-related to prosthesis use in patients who have suffered a traumatic limb amputation presents itself as a barrier to comfort, prosthesis use and overall quality of life. This review intends to encourage dermatologists to consider the use of botulinum toxin A or B for the treatment of hyperhidrosis in the residual limb and may serve as a stimulus for a modern, in-depth, and more comprehensive study. A review of the literature was conducted using the PubMed database, focusing on hyperhidrosis treatment after traumatic limb amputation. Articles discussing hyperhidrosis treatment for amputations secondary to chronic medical conditions were excluded. Seven case studies published over the last 12 years have demonstrated positive outcomes of this treatment strategy. Overall, there is little data examining this topic and current publications focus primarily on small case series. A larger, double-blind, placebo-controlled study would likely benefit veterans, service members, and civilians. PMID:25657907

  17. Effects of botulinum toxin type A on healing of injured skeletal muscles

    Directory of Open Access Journals (Sweden)

    Shokravi Ramin

    2007-01-01

    Full Text Available Objectives: (1 Evaluation of microscopic healing of skeletal muscle fibers after injuries, especially the arrangement of new muscle fibers and scar tissue diameter in the injury region. (2 Evaluation of alterations in microscopy of the healing procedure within skeletal muscles after injury following botulinum toxin type A (BTX -A induced muscle immobilization. Materials and Methods: The study was done on 12 white lab rabbits of either sex in a 6-month period. Results: The immobilization of skeletal muscle fibers as a result of the use of BTX-A after injury caused a qualitative increase in fibrous tissue formation in the area of injury, and the BTX-A-induced immobilization for a period of 6 months led to muscle atrophy.

  18. The effect of different localizing techniques in guiding botulinum toxin injection in the treatment of lower limb spasticity in cerebral palsy children%不同定位技术联合强化康复训练对脑瘫患儿下肢痉挛的影响

    Institute of Scientific and Technical Information of China (English)

    卢晓芳; 李海峰; 周雪娟; 金慧英; 王江平; 董庆

    2015-01-01

    Objective To observe the effect of free muscle localization and ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with rehabilitation training on lower limb spasm of cerebral palsy children.Methods Sixty-one cerebral palsy children with lower limb spasticity were randomly divided into a manual localizing group (31 cases) and an ultrasound-guided group (30 cases).The children of both groups underwent BTX-A injection at adductors,hamstrings and calf triceps.The former group was injected with bare hands,while the latter was injected under the guidance of ultrasound.Both groups were administered with rehabilitation training from the 3rd day onwards after injection.Before and 12 weeks after the injection,the modified Ashworth scale (MAS) and gross motor function scale (GMFM) were used to evaluate the lower limb spasticity and function in 2 groups.Results Before the injection,there was no significant difference between the 2 groups in terms of MAS and GMFM scores (P > 0.05).However,12 weeks after the injection,the average MAS scores of the two groups decreased,and that of the ultrasound-guided injection group (1.43 ±0.50) was significantly lower than that of the manual localizing group (1.77 ± 0.56).After the injection,the average GMFM scores of both groups increased,and that of the ultrasound-guided injection group was significantly higher than the manual localizing group (67.10 ± 11.25).Conclusion Ultrasound-guided injection of BTX-A with intensive rehabilitation training can significantly reduce the lower limb spasticity in children with cerebral palsy,and increase their motion of joint and motor function,and improve their posture and gait.%目的 观察徒手肌肉定位和超声引导下注射A型肉毒毒素(BTX-A)联合强化康复训练对脑瘫患儿下肢痉挛的影响.方法 按照随机数字表法将61例下肢痉挛脑瘫患儿分为徒手定位组(31例)和超声引导组(30例),2组患儿均接受BTX-A注射,注射部位均为

  19. Interneuronal Transfer and Distal Action of Tetanus Toxin and Botulinum Neurotoxins A and D in Central Neurons.

    Science.gov (United States)

    Bomba-Warczak, Ewa; Vevea, Jason D; Brittain, Joel M; Figueroa-Bernier, Annette; Tepp, William H; Johnson, Eric A; Yeh, Felix L; Chapman, Edwin R

    2016-08-16

    Recent reports suggest that botulinum neurotoxin (BoNT) A, which is widely used clinically to inhibit neurotransmission, can spread within networks of neurons to have distal effects, but this remains controversial. Moreover, it is not known whether other members of this toxin family are transferred between neurons. Here, we investigate the potential distal effects of BoNT/A, BoNT/D, and tetanus toxin (TeNT), using central neurons grown in microfluidic devices. Toxins acted upon the neurons that mediated initial entry, but all three toxins were also taken up, via an alternative pathway, into non-acidified organelles that mediated retrograde transport to the somato-dendritic compartment. Toxins were then released into the media, where they entered and exerted their effects upon upstream neurons. These findings directly demonstrate that these agents undergo transcytosis and interneuronal transfer in an active form, resulting in long-distance effects. PMID:27498860

  20. OPT技术联合A型肉毒毒素在面部除皱中的应用%Application of optima pulse technology united to Botulinum Toxin for correction of facial wrinkle

    Institute of Scientific and Technical Information of China (English)

    郭云; 王芳; 王爱玲; 邓兰

    2012-01-01

    Objective To observe the wrinkle reducing effect of OPT technology when used together with Botulinum Toxin. Methods OPT technology treated the small wrinkle site.and then The Botulinum Toxin was injected into the markpoint near the wrinkle. Results Half of year followed-up of thirty patients showed satisfactory results.The effective rate were 83%. Conclusion Combined use of injection of Botulinum Toxin and OPT technology for wrinkle reduction could be more comprehensive to enhance the efficacy of skin rejuvenation, and had a promising future in cosmetic surgery.%目的:观察OPT技术联合A型肉毒毒素在面部除皱中的临床应用效果.方法:首先用OPT技术治疗面部细小皱纹,然后在面部动力性皱纹处注射A型肉毒毒素.结果:共治疗120例,术后随访6~12个月,总有效率达83%,疗效满意.结论:OPT技术联合A型肉毒毒素应用于面部除皱术,可更全面地提升皮肤年轻化的疗效,在皮肤美容领域有着较好的应用前景.

  1. Questionnaire about the Adverse Events and Side Effects Following Botulinum Toxin A Treatment in Patients with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Izabela Blaszczyk

    2015-11-01

    Full Text Available Botulinum toxin A (BoNT-A injections for treatment of spasticity in patients with cerebral palsy (CP have been used for about two decades. The treatment is considered safe but a low frequency of adverse events (AE has been reported. A good method to report AEs is necessary to verify the safety of the treatment. We decided to use an active surveillance of treatment-induced harm using a questionnaire we created. We studied the incidence of reported AEs and side effects in patients with CP treated with BoNT-A. We investigated the relationship between the incidence of AEs or side effects and gender, age, weight, total dose, dose per body weight, Gross Motor Function Classification System (GMFCS and number of treated body parts. Seventy-four patients with CP participated in our study. In 54 (51% of 105 BoNT-A treatments performed in 45 (61% patients, there were 95 AEs and side effects reported, out of which 50 were generalized and/or focal distant. Severe AEs occurred in three patients (4%, and their BoNT-A treatment was discontinued. Consecutive collection of the AE and side-effect incidence using our questionnaire can increase the safety of BoNT-A treatment in patients with CP.

  2. Questionnaire about the Adverse Events and Side Effects Following Botulinum Toxin A Treatment in Patients with Cerebral Palsy

    Science.gov (United States)

    Blaszczyk, Izabela; Foumani, Nazli Poorsafar; Ljungberg, Christina; Wiberg, Mikael

    2015-01-01

    Botulinum toxin A (BoNT-A) injections for treatment of spasticity in patients with cerebral palsy (CP) have been used for about two decades. The treatment is considered safe but a low frequency of adverse events (AE) has been reported. A good method to report AEs is necessary to verify the safety of the treatment. We decided to use an active surveillance of treatment-induced harm using a questionnaire we created. We studied the incidence of reported AEs and side effects in patients with CP treated with BoNT-A. We investigated the relationship between the incidence of AEs or side effects and gender, age, weight, total dose, dose per body weight, Gross Motor Function Classification System (GMFCS) and number of treated body parts. Seventy-four patients with CP participated in our study. In 54 (51%) of 105 BoNT-A treatments performed in 45 (61%) patients, there were 95 AEs and side effects reported, out of which 50 were generalized and/or focal distant. Severe AEs occurred in three patients (4%), and their BoNT-A treatment was discontinued. Consecutive collection of the AE and side-effect incidence using our questionnaire can increase the safety of BoNT-A treatment in patients with CP. PMID:26561833

  3. Therapeutic synergism in the treatment of post-stroke arm paresis utilizing botulinum toxin, robotic therapy, and constraint-induced movement therapy.

    Science.gov (United States)

    Takebayashi, Takashi; Amano, Satoru; Hanada, Keisuke; Umeji, Atsushi; Takahashi, Kayoko; Koyama, Tetsuo; Domen, Kazuhisa

    2014-11-01

    Botulinum toxin type A (BtxA) injection, constraint-induced movement therapy (CIMT), and robotic therapy (RT) each represent promising approaches to enhance arm motor recovery after stroke. To provide more effective treatment for a 50-year-old man with severe left spastic hemiparesis, we attempted to facilitate CIMT with adaptive approaches to extend the wrist and fingers using RT for 10 consecutive weeks after BtxA injection. This combined treatment resulted in substantial improvements in arm function and the amount of arm use in activities of daily living, and may be effective for stroke patients with severe arm paresis. However, we were unable to sufficiently prove the efficacy of combined treatment based only on a single case. To fully elucidate the efficacy of the combined approach for patients with severe hemiparesis after stroke, future studies of a larger number of patients are needed.

  4. Tetanus toxin : primary structure, expression in E. coli, and homology with botulinum toxins

    NARCIS (Netherlands)

    Eisel, Ulrich; Jarausch, Wolfgang; Goretzki, Karin; Henschen, Agnes; Engels, Joachim; Weller, Ulrich; Hudel, Martina; Habermann, Ernst; Niemann, Heiner; Rott, R.

    1986-01-01

    A pool of synthetic oligonucleotides was used to identify the gene encoding tetanus toxin on a 75-kbp plasmid from a toxigenic non-sporulating strain of Clostridium tetani. The nucleotide sequence contained a single open reading frame coding for 1315 amino acids corresponding to a polypeptide with a

  5. Botulinum toxin type A for cephalic cutaneous allodynia in chronic migraine: a randomized, double-blinded, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Luciano Hollanda

    2014-12-01

    Full Text Available Cephalic allodynia (CA can be observed in 50-70% of patients with chronic migraine (CM. The aim of this trial was to assess the efficacy of botulinum toxin type A (Botx-A in the treatment of CA associated with CM. In this placebo-controlled trial, patients were randomized either into Botx-A or 0.9% saline injections and efficacy measures were assessed every 4 weeks for 3 months. Efficacy endpoints were number of migraine episodes associated with CA, changes from baseline in visual analogical scale scores for pain (VAS and frequency of common analgesics use for migraine. A total of 38 subjects were randomized to saline (n=18 or Botx-A (n=20. There were no significant differences in baseline between active intervention or placebo groups regarding mean age, number of headache episodes [mean 12.1 (9.22 and 17.00 (9.69 respectively; P=0.12], pain severity as measured by the VAS or frequency of analgesic use for headache episodes. Efficacy analysis showed that Botx-A injections led to an important decrease from baseline in the mean migraine episodes associated with CA after 12 weeks (5.20 versus 11.17; P=0.01. Also, VAS scores and frequency of analgesics use for headache were significantly reduced in the Botx-A group. This study suggests that Botx-A injections are superior to saline in the treatment of CA associated with CM, with mild self limited side effects.

  6. Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ece Unlu

    2010-01-01

    Full Text Available INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 ±3.2 years were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88, and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V. Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p0.05. Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

  7. Crystallization and preliminary X-ray analysis of the HA3 component of Clostridium botulinum type C progenitor toxin

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Toshio; Tonozuka, Takashi; Kotani, Mao; Obata, Kanae [Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509 (Japan); Oguma, Keiji [Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558 (Japan); Nishikawa, Atsushi, E-mail: nishikaw@cc.tuat.ac.jp [Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509 (Japan); CREST, Japan Science and Technology Agency (Japan)

    2007-12-01

    HA3, a 70 kDa haemagglutinating protein, is a precursor form of HA3a and HA3b, the subcomponents of Clostridium botulinum type C 16S progenitor toxin. In this report, recombinant HA3 protein was overexpressed in Escherichia coli, purified and crystallized. HA3, a 70 kDa haemagglutinating protein, is a precursor form of HA3a and HA3b, the subcomponents of Clostridium botulinum type C 16S progenitor toxin. In this report, recombinant HA3 protein was overexpressed in Escherichia coli, purified and crystallized. Diffraction data were collected to 2.6 Å resolution and the crystal belonged to the hexagonal space group P6{sub 3}. Matthews coefficient and self-rotation function calculations indicate that there is probably one molecule of HA3 in the asymmetric unit. A search for heavy-atom derivatives has been undertaken.

  8. The Role of Botulinum Toxin A in the Treatment of Raynaud Phenomenon.

    Science.gov (United States)

    Segreto, Francesco; Marangi, Giovanni Francesco; Cerbone, Vincenzo; Persichetti, Paolo

    2016-09-01

    Raynaud phenomenon (RP) is a transient digital ischemia that occurs after exposure to cold temperature or emotional distress. It presents with a triphasic course: the initial white phase is followed by cyanotic discoloration and, subsequently, erythema. The attacks may be associated with pain, paresthesia, and complicate with nonhealing ulceration often leading to amputation. To date, there are no clear-cut therapeutic guidelines and many medications are used off-label. Encouraging results were reported with the use of botulinum neurotoxin-A (BoNT-A). However, there is still ongoing debate regarding indications, contraindications, best injection technique, and mechanism of action. The aim of this study was to address these issues by providing an up-to-date and detailed overview of the use of BoNT-A in RP.A PubMed database search was conducted. The available studies and techniques were evaluated and compared.The search yielded a total of 29 studies. Ten papers, published between 2004 and 2014, were considered relevant. A total of 128 patients underwent BoNT-A injections. Seventy-five percent to 100 % of the patients reported pain reduction after treatment. Healing of ulcers was reported in 75% to 100% of the affected patients. The most common complication was temporary hand weakness, with an average incidence of 14.1%. Injections targeting the neurovascular bundle at or slightly proximal to the A1 pulley were the most commonly performed.Botulinum neurotoxin-A injection proved to be a valid approach in both primary and secondary RP. The available evidence shows the achievement of both symptomatic and functional improvements in this debilitating condition. However, the patient should be adequately informed about the risk of transient hand weakness. PMID:26808752

  9. A型肉毒毒素过敏事件的调查分析%Allergic reaction of the botulinum toxin type A

    Institute of Scientific and Technical Information of China (English)

    孙志成; 田茂生; 高锷; 王历; 鲁树荣

    2016-01-01

    Objective To investigate the cases of allergic reaction caused by botulinum toxin type A and the corresponding measures for its prevention and treatment.Methods The cases of allergic reaction caused by botulinum toxin type A were surveyed from 20 domestic medical cosmetic institutes from Jan.2013 to Jun.2016.Skin test was preformed for high risk population.Clinical data including customers' age,sex,injected site and times were collected in the hospitals,and cases of allergic reaction and their clinical manifestations were analyzed.Results Of 98000 cases injected with botulinum toxin type A,allergic shock occurred in 2 cases and allergic reaction in 21 cases,including wheal,redness,itching and swelling etc.Conclusions Allergic reaction caused by botulinum toxin type A is mainly related with the composition of botulinum toxin type A,cosmetics and physical constitution.Severe complications such as allergic shock should be paid high attention.Screening of the high risk population should be emphasized to avoid the allergic events.%目的 通过调查A型肉毒毒素过敏事件发生的基本情况,探讨其发生的原因及相应的防治措施.方法 调查国内20家医疗美容机构2013年1月至2016年6月A型肉毒毒素过敏反应发生情况,对高危人群进行皮试观察过敏情况.对注射A型肉毒毒素的美容就医者年龄、性别、注射部位以及被调查医疗美容机构年注射人次、有无A型肉毒毒素过敏病例,过敏病例的临床表现等进行分析.结果 9.8万人次A型肉毒毒素注射病例中,出现休克表现为2例,出现局部皮肤过敏表现为21例,皮肤过敏主要症状为局部风团、红肿、瘙痒和水肿等.A型肉毒毒素皮肤过敏反应主要与材料成分、化妆品和体质有关.结论 A型肉毒毒素过敏反应及过敏性休克等严重不良反应要引起高度重视.加强注射前高危人群筛查,避免过敏事件发生.

  10. Effect of botulinum toxin type A injection on hypertrophic scar in rabbit ear model%A型肉毒毒素局部应用对兔耳增生性瘢痕创面愈合和瘢痕增生的影响

    Institute of Scientific and Technical Information of China (English)

    王琳; 邰宁正; 范志宏

    2009-01-01

    目的 研究A型肉毒毒素对兔耳增生性瘢痕组织的影响.方法 8只日本大耳白兔,体重3 kg,建立兔耳增生性瘢痕模型.将兔耳创面分为A型肉毒毒素治疗组(T组)和瘢痕组(S组),每组48个创面.大体观察创面愈合时间和瘢痕增生情况.术后28 d,同法另取4只兔子的兔耳腹面健康皮肤为空白组(B组),收集标本.测量S、T组标本HE切片的瘢痕增生指数HI,流式细胞仪分析2组标本中成纤维细胞的细胞周期,western-blot检测S、T、B组标本中Ⅰ、Ⅲ型胶原的蛋白表达.结果 ①T组标本的瘢痕增生指数HI较S组显著降低,P<0.01;②蛋白水平上,T组的胶原Ⅰ、Ⅲ蛋白表达和胶原Ⅰ/Ⅲ比值均较s组显著降低,P<0.01;③S组分布于G2-M期和S期的成纤维细胞较T组显著增多,而静止期G0-G1的细胞则显著减少,P<0.05.结论 A型肉毒毒素局部应用能抑制兔耳增生瘢痕的形成.抑制成纤维细胞的增殖活性,减少瘢痕组织中Ⅰ、Ⅲ型胶原的合成,降低胶原Ⅰ/Ⅲ比值,为其治疗增生性瘢痕的临床应用提供了一定的理论依据.%Objective To investigate the effect of botulinum toxin type A (Botox A) injection on hypertrophic scar in rabbit ear model. Methods The hypertrophic scar model was established in 16 Japanese rabbits' ears. These wounds were divided into two groups as group T(treated with Botox A, n =48) and group S (not treated, n = 48). The wounds healing times and scar hypertrophy were observed with 8 specimen of normal skin at the rabbit ears as sham group B. HE stain was used to assess the hypertrophic index(HI). The expression of collagen Ⅰ and Ⅲ was tested by western-blot. The cell cycle of fibroblasts was studied by flow cytometry. Results The [] was significantly lower in group T than in group S(P < 0.01). The expression of collagen Ⅰ and Ⅲ, as well as the ratio of Ⅰ to Ⅲ, was markedly stronger in group S than in group T(P < 0.01). Compared with group T, more

  11. A Randomized Controlled Trial Comparing Botulinum Toxin A Dosage in the Upper Extremity of Children with Spasticity

    Science.gov (United States)

    Kawamura, Anne; Campbell, Kent; Lam-Damji, Sophie; Fehlings, Darcy

    2007-01-01

    This study compared the effects of low and high doses of botulinum toxin A (BTX-A) to improve upper extremity function. Thirty-nine children (22 males, 17 females) with a mean age of 6 years 2 months (SD 2y 9mo) diagnosed with spastic hemiplegia or triplegia were enrolled into this double-blind, randomized controlled trial. The high-dose group…

  12. Randomised double blind placebo controlled trial of the effect of botulinum toxin on walking in cerebral palsy

    OpenAIRE

    Ubhi, T; Bhakta, B; Ives, H; Allgar, V.; Roussounis, S

    2000-01-01

    BACKGROUND—Cerebral palsy is the commonest cause of severe physical disability in childhood. For many years treatment has centred on the use of physiotherapy and orthotics to overcome the problems of leg spasticity, which interferes with walking and can lead to limb deformity. Intramuscular botulinum toxin (BT-A) offers a targeted form of therapy to reduce spasticity in specific muscle groups.
AIMS—To determine whether intramuscular BT-A can improve walking in children wi...

  13. A cross-sectional structured survey of patients receiving botulinum toxin type A treatment for blepharospasm.

    Science.gov (United States)

    Fezza, John; Burns, John; Woodward, Julie; Truong, Daniel; Hedges, Thomas; Verma, Amit

    2016-08-15

    To characterize satisfaction with current standard-of-care botulinum neurotoxin type A (BoNT/A) treatment for blepharospasm, we performed a cross-sectional, structured survey in subjects with blepharospasm who had received ≥2 BoNT/A cycles. Subjects were interviewed immediately before re-injection to evaluate treatment satisfaction, time course of treatment effects, preferred injection intervals, Jankovic Rating Scale (JRS), and Blepharospasm Disability Index (BSDI). Subjects' (n=114) last treatment was onabotulinumtoxinA (n=78), incobotulinumtoxinA (n=35), or abobotulinumtoxinA (n=1). The most frequent injection interval was 12weeks (46.5% subjects); 30.7% had an interval >12weeks. The main rationale for interval choice was "to maintain treatment efficacy" (44.7%). However, 36.6% reported that treatment effects usually declined within 8weeks; 69.6% within 10weeks. JRS and BSDI scores indicated re-emergence of symptoms before re-injection, with 70.2% and 73.7% of subjects reporting difficulties to drive and read, respectively. Overall, treatment satisfaction was high, but declined at the end of the cycle. Many subjects (52.3%) would prefer an injection interval of <12weeks; 30.6% of <10weeks. In conclusion, the survey results indicate that blepharospasm symptoms, such as difficulties to drive and read, re-emerge at the end of a BoNT treatment cycle and that flexible, individualized treatment intervals may improve treatment satisfaction and outcomes. PMID:27423565

  14. Factors affecting growth and toxin production by Clostridium botulinum type E on irradiated (0.3 Mrad) chicken skins

    International Nuclear Information System (INIS)

    A model system (chicken skins with chicken exudate) was used to determine if Clostridium botulinum type E (Beluga) spores, stressed by low dose irradiation, would develop and produce toxin at abuse temperatures of 10 and 300C in the absence of characteristic spoilage. Unstressed spores germinated, multiplied, and produced toxin on vacuum-packed chicken skins, stored at either 30 or 100C. Cell numbers increased faster and toxin was evident sooner at 300C than at 100C. At 300C, growth occurred and toxin was produced more slowly when samples were incubated aerobically than anaerobically. When samples were incubated aerobically at 100C, no toxin was detected within a test period of 14 days. An irradiation dose of 0.3 Mrad at 50C reduced a spore population on vacuum-sealed chicken skins by about 90%. The surviving population produced toxin at 300C under either aerobic or anaerobic conditions, at 100C no toxin was detected even on skins incubated anaerobically. Under the worst conditions (300C, vacuum packed) toxin was not detected prior to characteristic spoilage caused by the natural flora surviving 0.3 Mrad

  15. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: A randomized clinical trial.

    Science.gov (United States)

    De Carli, Bethânia Molin Giaretta; Magro, Alessandra Kuhn Dall; Souza-Silva, Bianca Núbia; Matos, Felipe de Souza; De Carli, João Paulo; Paranhos, Luiz Renato; Magro, Eduardo Dall

    2016-06-01

    This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening. PMID:27045280

  16. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: A randomized clinical trial.

    Science.gov (United States)

    De Carli, Bethânia Molin Giaretta; Magro, Alessandra Kuhn Dall; Souza-Silva, Bianca Núbia; Matos, Felipe de Souza; De Carli, João Paulo; Paranhos, Luiz Renato; Magro, Eduardo Dall

    2016-06-01

    This study conducted a randomized clinical trial in 15 patients, who sought care at the Dental Clinic of the University of Passo Fundo, in order to compare the use of low-level laser and botulinum toxin in the treatment of myofascial pain and whether they alter the mouth opening of patients with temporomandibular disorder. The patients were divided into two groups: the Laser group received low-level GaAlAs laser, 100mW of power at a wavelength of 830nm in continuous light emission; and the Toxin group received 30U of botulinum toxin type A (BTX-A) in the first session, and 15U after fifteen days. The assessments were performed by measuring pain with Visual Analogue Scale (VAS), and mouth opening with a digital caliper. Data were submitted to Student's t test at 5% significance level. Regarding pain symptoms, the results indicate that groups treated with laser and toxin registered 7U in VAS, at day 5 the scores were 4.75 and 4.86U, respectively. The laser worked faster (day 12) at 2.75U, and the group treated with BTX-A registered 2.86U at day 30. Both therapies investigated were effective in reducing pain, but the effect of low-level laser was faster than the use of BTX-A. Both treatments showed no statistically significant improvement in mouth opening.

  17. Lumbar Sympathetic Block with Botulinum Toxin Type B for Complex Regional Pain Syndrome: A Case Study.

    Science.gov (United States)

    Choi, Eunjoo; Cho, Chan Woo; Kim, Hye Young; Lee, Pyung Bok; Nahm, Francis Sahngun

    2015-01-01

    Lumbar sympathetic block (LSB) is an effective method for relief of sympathetically mediated pain in the lower extremities. To prolong the sympathetic blockade, sympathetic destruction with alcohol or radiofrequency has been used. The pre-ganglionic sympathetic nerves are cholinergic, and botulinum toxin (BTX) has been found to inhibit the release of acetylcholine at the cholinergic nerve terminals. Moreover, BTX type B (BTX-B) is more convenient to use than BTX type A. Based on these findings, we performed LSB on the 2 patients with complex regional pain syndrome (CRPS) in the lower extremity. Levobupivacaine 0.25% 5 mL mixed with BTX-B 5,000 IU was given under fluoroscopic guidance. Two months after LSB with BTX-B, pain intensity and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were significantly reduced. Allodynia and coldness disappeared and skin color came back to normal. In conclusion, BTX-B can produce an efficacious and durable sympathetic blocking effect on patients with CRPS.

  18. The first non Clostridial botulinum-like toxin cleaves VAMP within the juxtamembrane domain

    Science.gov (United States)

    Zornetta, Irene; Azarnia Tehran, Domenico; Arrigoni, Giorgio; Anniballi, Fabrizio; Bano, Luca; Leka, Oneda; Zanotti, Giuseppe; Binz, Thomas; Montecucco, Cesare

    2016-01-01

    The genome of Weissella oryzae SG25T was recently sequenced and a botulinum neurotoxin (BoNT) like gene was identified by bioinformatics methods. The typical three-domains organization of BoNTs with a N-terminal metalloprotease domain, a translocation and a cell binding domains could be identified. The BoNT family of neurotoxins is rapidly growing, but this was the first indication of the possible expression of a BoNT toxin outside the Clostridium genus. We performed molecular modeling and dynamics simulations showing that the 50 kDa N-terminal domain folds very similarly to the metalloprotease domain of BoNT/B, whilst the binding part is different. However, neither the recombinant metalloprotease nor the binding domains showed cross-reactivity with the standard antisera that define the seven serotypes of BoNTs. We found that the purified Weissella metalloprotease cleaves VAMP at a single site untouched by the other VAMP-specific BoNTs. This site is a unique Trp-Trp peptide bond located within the juxtamembrane segment of VAMP which is essential for neurotransmitter release. Therefore, the present study identifies the first non-Clostridial BoNT-like metalloprotease that cleaves VAMP at a novel and relevant site and we propose to label it BoNT/Wo. PMID:27443638

  19. The first non Clostridial botulinum-like toxin cleaves VAMP within the juxtamembrane domain.

    Science.gov (United States)

    Zornetta, Irene; Azarnia Tehran, Domenico; Arrigoni, Giorgio; Anniballi, Fabrizio; Bano, Luca; Leka, Oneda; Zanotti, Giuseppe; Binz, Thomas; Montecucco, Cesare

    2016-07-22

    The genome of Weissella oryzae SG25T was recently sequenced and a botulinum neurotoxin (BoNT) like gene was identified by bioinformatics methods. The typical three-domains organization of BoNTs with a N-terminal metalloprotease domain, a translocation and a cell binding domains could be identified. The BoNT family of neurotoxins is rapidly growing, but this was the first indication of the possible expression of a BoNT toxin outside the Clostridium genus. We performed molecular modeling and dynamics simulations showing that the 50 kDa N-terminal domain folds very similarly to the metalloprotease domain of BoNT/B, whilst the binding part is different. However, neither the recombinant metalloprotease nor the binding domains showed cross-reactivity with the standard antisera that define the seven serotypes of BoNTs. We found that the purified Weissella metalloprotease cleaves VAMP at a single site untouched by the other VAMP-specific BoNTs. This site is a unique Trp-Trp peptide bond located within the juxtamembrane segment of VAMP which is essential for neurotransmitter release. Therefore, the present study identifies the first non-Clostridial BoNT-like metalloprotease that cleaves VAMP at a novel and relevant site and we propose to label it BoNT/Wo.

  20. Lumbar Sympathetic Block with Botulinum Toxin Type B for Complex Regional Pain Syndrome: A Case Study.

    Science.gov (United States)

    Choi, Eunjoo; Cho, Chan Woo; Kim, Hye Young; Lee, Pyung Bok; Nahm, Francis Sahngun

    2015-01-01

    Lumbar sympathetic block (LSB) is an effective method for relief of sympathetically mediated pain in the lower extremities. To prolong the sympathetic blockade, sympathetic destruction with alcohol or radiofrequency has been used. The pre-ganglionic sympathetic nerves are cholinergic, and botulinum toxin (BTX) has been found to inhibit the release of acetylcholine at the cholinergic nerve terminals. Moreover, BTX type B (BTX-B) is more convenient to use than BTX type A. Based on these findings, we performed LSB on the 2 patients with complex regional pain syndrome (CRPS) in the lower extremity. Levobupivacaine 0.25% 5 mL mixed with BTX-B 5,000 IU was given under fluoroscopic guidance. Two months after LSB with BTX-B, pain intensity and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were significantly reduced. Allodynia and coldness disappeared and skin color came back to normal. In conclusion, BTX-B can produce an efficacious and durable sympathetic blocking effect on patients with CRPS. PMID:26431145

  1. Quantification of Clostridium botulinum Toxin Gene Expression by Competitive Reverse Transcription-PCR

    OpenAIRE

    McGrath, S.; Dooley, J. S. G.; Haylock, R. W.

    2000-01-01

    Clostridium botulinum produces a characteristic botulinum neurotoxin which can cause an often fatal neuroparalytic condition known as botulism. Although food-borne botulism is rare, critical screening by food companies is necessary to ensure that food products are safe. At present, the food industry assesses the risks of botulinum neurotoxin production by challenge testing to check any new food products and to check the efficacy of new storage regimes. Challenge testing involves artificial in...

  2. 踝足矫形器联合肉毒毒素治疗痉挛型脑性瘫痪儿童尖足畸形的疗效观察%Ankle-foot orthosis combined with botulinum toxin type A injection in treating tip foot deformity in children with cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    周陶成; 童光磊; 张敏; 李司南; 易昕; 陈露露; 温祖芳; 康倩倩; 陈婧

    2015-01-01

    目的 观察踝足矫形器(A FO)联合A型肉毒毒素(BTX-A)肌肉注射治疗痉挛型脑瘫患儿尖足的疗效.方法 痉挛型脑瘫患儿尖足畸形50例,采用随机数字表法将其分为对照组和观察组,每组25例,对照组患儿采用BTX-A肌肉注射与运动康复训练,观察组在对照组基础上加用AFO训练,与其运动康复训练同步.分别于治疗前、治疗后1、3和6个月,使用量角器测量踝关节的被动背屈角(APROM),改良Ashworth量表的评分(MAS)以及粗大运动功能量表(GMFM-88)的D区(站立)和E区(走跑跳)评分.结果 治疗前,观察组APROM、MAS和GMFM(D、E)分别为(109.25±12.38)°、(3.12±0.56)分和(55.32±11.23)分,与对照组[(107.11±13.44)°、(3.05±0.66)分和(56.21±10.81)分]比较,差异均无统计学意义(P>0.05).2组患儿的APROM、MAS和GMFM评分在治疗后1、3和6个月时与组内与治疗前比较,差异均有统计学意义(P<0.05);治疗后,观察组APROM、MAS和GMFM评分分别与对照组治疗比较,差异亦均有统计学意义(P<0.05).2组治疗后各时间点之间的评估指标比较,观察组差异均有统计学意义;对照组治疗后1个月与治疗后3个月比较,差异有统计学意义(P<0.05),治疗后3个月和治疗后6个月比较,差异无统计学意义(P>0.05).结论 AFO联合BTX-A疗法能进一步缓解痉挛型脑瘫患儿的下肢痉挛程度,减轻尖足异常姿势,维持时间更持久.%Objective To observe the clinical efficacy of ankle-foot orthosis (AFO) combined with botulinum toxin type A (BTX-A) injection in treating tip foot deformity in children with cerebral palsy (CP).Methods Fifty CP children with tip foot deformity were selected and randomly divided into a control group and an observation group according to a random number table.Both groups were given BTX-A injection, and the observation group was additionally treated with AFO.All children were assessed before, 1 month, 3 months and 6 months after the treatment

  3. OBSERVATION OF EFFECT ON PAIN AND HEMORRHAGE BY ICE COMPRESS BEFORE BOTULINUM TOXIN INJECTIONS FOR CEREBRAL PALSY IN CHILDREN%脑性瘫痪儿童肉毒素注射前冰敷对注射疼痛及出血的影响

    Institute of Scientific and Technical Information of China (English)

    沈慧玲

    2008-01-01

    目的 比较2种肉毒素注射治疗前冰敷对脑性瘫痪儿童注射出血和疼痛的影响,探讨安全的肉毒素注射方法.方法 将126例进行A型肉毒素(botulinum toxin A,BTX-A)治疗的脑性瘫痪(痉挛型)患者,随机分为2组,每组63例,观察组患者采用注射治疗前冰敷法,对照组治疗前不作冰敷,比较2种方法对注射疼痛有无影响及注射出血的发生率.结果 观察组注射A型肉毒素治疗时出血比对照组显著减少,没有发生注射后血肿,注射过程中疼痛明显减轻.结论 注射前冰敷能减少肉毒素注射引起的出血及疼痛,提高肉毒毒素注射的安全系数.

  4. Analgesic effects of intra-articular botulinum toxin Type B in a murine model of chronic degenerative knee arthritis pain

    Directory of Open Access Journals (Sweden)

    Stephanie Anderson

    2010-09-01

    Full Text Available Stephanie Anderson1,2, Hollis Krug1,2, Christopher Dorman1, Pari McGarraugh1, Sandra Frizelle1, Maren Mahowald1,21Rheumatology Section, Veteran’s Affairs Medical Center, Minneapolis, Minnesota; 2Division of Rheumatology and Autoimmune Diseases, University of Minnesota Medical School, Minneapolis, Minnesota, USAObjective: To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B in a murine model of chronic degenerative arthritis pain.Methods and materials: Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior and joint tenderness evaluation (evoked pain response. Strength was measured as ability to grasp and cling.Results: Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.Conclusions: This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis

  5. Effect of botulinum toxin type A injection on the expression of substance P, TGF-β1 and α-SMA in rabbit ear model of hypertrophic scar%A型肉毒毒素对兔耳增生性瘢痕组织中P物质、β1转移生长因子、α平滑肌肌动蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    王琳; 邰宁正; 范志宏

    2009-01-01

    Objective To investigate the effect of botulinum toxin type A injection on the expres-sion of substance P, TGF-β1 and α-SMA in rabbit ear model of hypertrophic scar. Methods The hyper-trophic sear model was established in 24 Japanese rabbits'ears. The wounds in ventral surface of ear were divided in Group I (lateral wounds) and Group S (medial wounds), 3 wounds each side per ear, totally 72 wounds each group. The wound-healing time and the growth of scar were observed and recorded. On post-wounding day 28, the wounds were created in another 6 rabbits in the same way and the normal skin were harvested as Group C. Likewise, the scar samples in Groups I and S were harvested. The mRNA expression of substance P, TGF-β1 and α-SMA were detected quantitatively by using real-time PCR and α-SMA was also detected with Western blot. Results No difference between the ratio of healed or infec-tious wounds on post-wounding day 14. The mRNA expression of SP, TGF-β1 and α-SMA in Group I was significantly lower than Group S, but higher than those in Group C (PI组>C组.结论 BTA注射不延迟创面愈合,并减少了兔耳增生瘢痕中SP、TGF-β1和α-SMA的mRNA表达,为其治疗增生性瘢痕的临床应用提供了一定的理论依据.

  6. A型肉毒毒素进行面部除皱的临床效果研究%Study on the clinical effect of Botulinum toxin A for removing facial wrinkles

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    目的:探讨和研究应用A型肉毒毒素进行面部除皱的临床效果。方法:选取2014年11月-2015年2月进行面部注射除皱的患者,对患者注射部位术后1周、半个月、1个月、3个月、半年进行对比。结果:所有患者注射A型肉毒毒素之后,达到很好的除皱效果。结论:使用A型肉毒毒素来去除面部的皱纹,其疗效非常明显,副作用小,患者痛苦少,是一种比较安全可靠的面部年轻化方式。%Objective To explore and research application of botulinum toxin A for the clinical effect of facial wrinkles. Methods Selection the patients with facial anti-wrinkle injection from November 2014 to February 2015,injection site on the patients,after a week,half a month,a month,three months,six months were compared. Results All of the patients after injections of botulinum toxin A,achieve good anti-wrinkle effect. Conclusion Using botulinum toxin to remove facial wrinkles,its curative effect is very obvious,side effect is small.Have no language recovery time,less pain A very safe and reliable way.

  7. Tratamiento del Síndrome de Dolor Miofascial con Toxina Botulínica tipo A Botulinum toxin type A in the management of Myofascial pain syndrome

    Directory of Open Access Journals (Sweden)

    M. Castro

    2006-03-01

    study. The aim of the study was to evaluate the clinical efficacy and safety of the muscular injection of the botulinum toxin in reducing pain in the MPS in 20 patients. All patients had a diagnostic injection of the lumbar musculature or the piriformis muscle of 8 ml of 0.2% ropi-vacaine and 6 mg of sodium betamethasone phosphate and 6 mg of acetate betamethasone in each muscle. We used anatomical references to localise each muscle and we injected 1 ml of hydrosoluble contrast to confirm by radioscopy guidance the correct localization of the needle in the muscle to treat. The administration of the botulinum toxin was carried out using the same method used for the diagnostic infiltrations. We decided to use one dose of 250 U of Dysport® in each muscle and we exceeded 1000 U in none patient. The assessment of the treatment efficacy was based on the pain reduction according to the visual analog scale (VAS on the first day of the injection (VAS 1, at day 15 (VAS 15, day 30 (VAS 30 and day 90 (VAS 90 after insertion of the botulinum toxin and the test of Lattinen was evaluated before the treatment (TLT 1 and at the completion of the study (TLT 2. All patients were asked regarding side effects and the grade of satisfaction at the end of the study was defined as excellent, good, regular or bad. Results: In all patients, the diagnostic injection was considerate positive with the posterior administration of the botulinum toxin. There was at least a reduction of 50% of the pain in the EVA in the 20 cases at day 15 and 30. At day 90, the reduction of the pain at 50% was maintained in 13 patients and less than 50% in the rest of the patients. The initial median EVA was 7.7 ± 1.2 standard desvia-tion and the TLT median initial of 12± 2.3. The evolution of the EVA median in the following controls was EVA 15 = 3,34 ± 2,5; EVA 30 = 3,54 ± 2,37 y EVA 90 = 4,94 ± 2,83. The median TLT at day 90 was de 7,43 ± 3,49. Only one patient referred mild muscle weakness of the lower limbs

  8. Potential Effect of Liposomes and Liposome-Encapsulated Botulinum Toxin and Tacrolimus in the Treatment of Bladder Dysfunction.

    Science.gov (United States)

    Janicki, Joseph J; Chancellor, Michael B; Kaufman, Jonathan; Gruber, Michele A; Chancellor, David D

    2016-03-18

    Bladder drug delivery via catheter instillation is a widely used treatment for recurrence of superficial bladder cancer. Intravesical instillation of liposomal botulinum toxin has recently shown promise in the treatment of overactive bladder and interstitial cystitis/bladder pain syndrome, and studies of liposomal tacrolimus instillations show promise in the treatment of hemorrhagic cystitis. Liposomes are lipid vesicles composed of phospholipid bilayers surrounding an aqueous core that can encapsulate hydrophilic and hydrophobic drug molecules to be delivered to cells via endocytosis. This review will present new developments on instillations of liposomes and liposome-encapsulated drugs into the urinary bladder for treating lower urinary tract dysfunction.

  9. High dose botulinum toxin A for the treatment of lower extremity hypertonicity in children with cerebral palsy

    OpenAIRE

    Willis, Allison W.; Crowner, Beth; Brunstrom, Janice E; Kissel, Abigail; Racette, Brad A.

    2007-01-01

    The aim of this study was to determine the safety profile of high dose (15–25 units/kg) of botulinum toxin A (BTX-A) in children with cerebral palsy (CP) and increased lower extremity muscle tone. We performed a retrospective review of 929 patient encounters at the Movement Disorders Center at Washington University. A total of 261 patients (105 females; 156 males) were treated during these visits, ages 6 months to 21 years (mean 8y 4mo [SD 4y 8mo]). Ambulatory ability at the time of BTX-A inj...

  10. Botulinum toxin treatment failures in cervical dystonia: causes, management, and outcomes.

    Science.gov (United States)

    Jinnah, H A; Goodmann, Emily; Rosen, Ami R; Evatt, Marian; Freeman, Alan; Factor, Stewart

    2016-06-01

    Botulinum toxin (BoNT) is highly effective in the treatment of cervical dystonia (CD), yet a significant proportion of patients report low levels of satisfaction following treatment and fail to follow up for repeated treatments. The goal of this study was to determine the reasons that some patients have unsatisfactory responses. A total of 35 subjects who came to our center requesting alternative treatments due to unsatisfactory responses following BoNT treatment for CD were evaluated. Included were 26 women and 9 men with an average age of 57.1 years (range 25-82 years), and an average duration of illness of 12.5 years (range 1-55 years). Details of unsatisfactory BoNT treatments were methodically collected by a movement specialist using a standardized intake form, including provider subspecialty, product used, the number of satisfactory or unsatisfactory trials, doses given, specific muscles treated, the use of electromyographic guidance, side effects, and tests of resistance. The specialist then provided repeat treatments if indicated, and followed each case until the reasons for unsatisfactory outcomes could be determined. Multiple reasons for unsatisfactory outcomes were found. They included suboptimal BoNT doses, suboptimal muscle targeting, intolerable side effects, complex movement patterns, discordant perceptions, and incorrect diagnoses. Only one patient was functionally resistant to BoNT. Of 32 subjects who received repeat BoNT treatments, 25 (78 %) achieved satisfactory responses after revision of the original treatment plan. These results indicate that the majority of unsatisfactory responses to BoNT treatment of CD were caused by correctible factors and imply a need for improved education regarding optimal treatment methods. PMID:27113604

  11. Botulinum toxin type A in refractory chronic migraine: an open-label trial Toxina botulínica tipo A no tratamento da enxaqueca refratária: um estudo aberto

    OpenAIRE

    Carla Menezes; Bernardo Rodrigues; Elza Magalhães; Ailton Melo

    2007-01-01

    Botulinum toxin type A (BT-A) has been described as an important strategy to various types of pain such as cervical dystonia, myofascial pain syndrome and headache. Although BT-A efficacy has not been proven in tension type headache, its use in migraine continues controversial. In this open trial, we evaluated the efficacy of BT-A in refractory migraine. BT-A was injected in patients diagnosed with migraine who had previously used three classes of prophylactic drugs by at least one year with ...

  12. Conformational divergence in the HA-33/HA-17 trimer of serotype C and D botulinum toxin complex.

    Science.gov (United States)

    Sagane, Yoshimasa; Hayashi, Shintaro; Akiyama, Tomonori; Matsumoto, Takashi; Hasegawa, Kimiko; Yamano, Akihito; Suzuki, Tomonori; Niwa, Koichi; Watanabe, Toshihiro; Yajima, Shunsuke

    2016-08-01

    Clostridium botulinum produces a large toxin complex (L-TC) comprising botulinum neurotoxin associated with auxiliary nontoxic proteins. A complex of 33- and 17-kDa hemagglutinins (an HA-33/HA-17 trimer) enhances L-TC transport across the intestinal epithelial cell layer via binding HA-33 to a sugar on the cell surface. At least two subtypes of serotype C/D HA-33 exhibit differing preferences for the sugars sialic acid and galactose. Here, we compared the three-dimensional structures of the galactose-binding HA-33 and HA-33/HA-17 trimers produced by the C-Yoichi strain. Comparisons of serotype C/D HA-33 sequences reveal a variable region with relatively low sequence similarity across the C. botulinum strains; the variability of this region may influence the manner of sugar-recognition by HA-33. Crystal structures of sialic acid- and galactose-binding HA-33 are broadly similar in appearance. However, small-angle X-ray scattering revealed distinct solution structures for HA-33/HA-17 trimers. A structural change in the C-terminal variable region of HA-33 might cause a dramatic shift in the conformation and sugar-recognition mode of HA-33/HA-17 trimer. PMID:27237978

  13. Striving for more good days: patient perspectives on botulinum toxin for the treatment of cervical dystonia

    Science.gov (United States)

    Poliziani, Michele; Koch, Marco; Liu, Xierong

    2016-01-01

    Background The recommended reinjection interval for botulinum neurotoxin (BoNT) formulations in the treatment of cervical dystonia (CD) is generally ≥12 weeks, though intervals ≥10 weeks are approved for incobotulinumtoxinA in Europe. However, recurring symptoms can occur before the end of this period. Using qualitative research, we sought a greater understanding of disease burden, unmet patient needs, and barriers to treatment. Methods We conducted online semistructured, focus-group discussions, and online forum follow-up discussions among patients with CD, focusing on disease burden, patient needs, injection cycle preferences, and relationships with health care professionals. A subset of patients was also questioned in telephone interviews about individual experiences of CD and BoNT treatment. All participants were UK residents who had received onabotulinumtoxinA or abobotulinumtoxinA for CD for ≥1 year. Results Thirty-one patients (81% female; mean duration of CD 16.4 [range 4–31] years; mean BoNT injection cycle length 12.8 weeks) participated in the online focus-group and forum follow-up discussions. Of these, seven patients participated in telephone interviews. All had recurring symptoms between treatments, which substantially impacted on their work, family, and social life. Symptom severity fluctuated throughout an injection cycle and differed between patients and across injection cycles. Participants’ relationships with health care professionals and treatment satisfaction varied greatly. Many participants wanted longer-lasting and/or more stable symptom relief with shorter and/or more flexible injection intervals, according to individual needs. Lack of health care resources, long journeys to treatment centers, and immunogenicity/side-effect concerns were perceived as the main barriers to more flexible treatment. Conclusion The high burden of recurring primary and secondary symptoms of CD considerably affects patients’ quality of life. Patient

  14. ADP-ribosylation of actins in fibroblasts and myofibroblasts by botulinum C2 toxin: Influence on microfilament morphology and migratory behavior

    DEFF Research Database (Denmark)

    Rønnov-Jessen, Lone; Petersen, Ole William

    1996-01-01

    botulinum C2 toxin. The substrate for C2 toxin is globular actin, which upon ribosylation cannot incorporate into microfilaments. The pattern of actin ADP-ribosylation in (myo)fibroblasts in the presence of [32P]NAD was analyzed by isoelectric focusing, fluorography and immunoblotting. The influence of C2...... toxin on microfilaments in intact cells was further assessed by immunofluorescence, and motility was measured in a mass migration assay and by computerized video time-lapse microscopy. We show here that C2 toxin specifically ribosylates - and -actin in both fibroblasts and myofibroblasts. Whereas...

  15. A型肉毒毒素治疗颞下颌关节紊乱病的临床研究%The use of botulinum toxin A for the treatment of temporomandibular joint disorder

    Institute of Scientific and Technical Information of China (English)

    刘荣光; 范建本; 王颖; 任大元

    2001-01-01

    Objective To evaluate the clinical efficacy of botulinum toxin A in the treatment of temporomandibular joint disorder (TMD).Methods 11 patients with TMD were treated with 150 units of botulinum toxin A.Both masseter muscles were injected with 50 units each.Similarly,both temporalis muscles received 25 units each.Clinical data including maximum mouth opening,pain,subjective function and tenderness to palpation were collected and then analyzed.Results The maximum mouth opening,pain,subjective function and tenderness to palpation of the patients improved significantly (P<0.05) at different period of time after injection.Conclusion The use of botulinum toxin A for treatment of TMD is effective in reducing pain,increasing mouth opening and improving quality of life in patients with TMD.%目的评价A型肉毒毒素局部注射治疗颞下颌关节紊乱病(TMD)的临床疗效。方法对11例经保守治疗无效的TMD患者,给予局部注射A型肉毒毒素150U,双侧嚼肌各50U,双侧颞肌各25U。分析治疗前后不同时期患者的最大张口度、疼痛值、口颌功能及局部压痛值的变化。结果治疗后不同时期患者最大张口度、疼痛、口颌功能及局部压痛均较治疗前有显著改善(P<0.05)。结论 A型肉毒毒素局部注射治疗TMD,能有效改善患者的张口度,缓解疼痛。

  16. Regional diffusion of botulinum toxin in facial muscles: a randomised double-blind study and a consideration for clinical studies with split-face design.

    Science.gov (United States)

    Punga, Anna Rostedt; Eriksson, Annika; Alimohammadi, Mohammad

    2015-11-01

    Despite the extensive use of botulinum toxin A (BoNTA) in medical and cosmetic treatments, the potential spreading of BoNTA to surrounding tissues remains unknown. A patient with hemifacial paralysis upon blepharospasm treatment with low dose of BoNTA, prompted us to investigate the spreading effect. A randomised, double-blind study was conducted in which 5 healthy women (33-52 years) were treated with different doses of onabotulinum toxin unilaterally in the corrugator muscle. Parameters of efficacy and diffusion (CMAP; EMG and jitter analysis) in both glabellar and frontalis muscles were assessed at baseline, 2 and 4 weeks following BoNTA injection. CMAP of the treated glabellar muscles was reduced to approximately 40% in all dose groups. Additionally, contralateral CMAP reduction was observed in 3 of 5 subjects. These data confirm regional diffusion of BoNTA in facial muscle application, which raises question on the reliability of split-face models in BoNTA studies. PMID:25766591

  17. Regional Diffusion of Botulinum Toxin in Facial Muscles : A Randomised Double-blind Study and a Consideration for Clinical Studies with Split-face Design

    OpenAIRE

    Punga, Anna Rostedt; Eriksson, Annika; Alimohammadi, Mohammad

    2015-01-01

    Despite the extensive use of botulinum toxin A (BoNTA) in medical and cosmetic treatments, the potential spreading of BoNTA to surrounding tissues remains unknown. A patient with hemifacial paralysis upon blepharospasm treatment with low dose of BoNTA, prompted us to investigate the spreading effect. A randomised, double-blind study was conducted in which 5 healthy women (33-52 years) were treated with different doses of onabotulinum toxin unilaterally in the corrugator muscle. Parameters of ...

  18. Functional effects of botulinum toxin type-A treatment and subsequent stretching of spastic calf muscles: a study in patients with hereditary spastic paraplegia

    NARCIS (Netherlands)

    Niet, M. de; Bot, S.T. de; Warrenburg, B.P.C. van de; Weerdesteijn, V.G.M.; Geurts, A.C.H.

    2015-01-01

    OBJECTIVE: Although calf muscle spasticity is often treated with botulinum toxin type-A, the effects on balance and gait are ambiguous. Hereditary spastic paraplegia is characterized by progressive spasticity and relatively mild muscle weakness of the lower limbs. It is therefore a good model to eva

  19. The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

  20. 肉毒杆菌及肉毒毒素研究进展%Progress in Research on Bacillus botulinus and Botulinum Toxins

    Institute of Scientific and Technical Information of China (English)

    赵思俊; 李雪莲; 曹旭敏; 王娟; 王玉东; 王君玮; 曲志娜

    2013-01-01

    肉毒杆菌是一种致命病菌,能引起肉毒中毒症。肉毒杆菌作为影响食品安全的一个重要风险因素,尤其是在新西兰恒天然公司部分产品受到肉毒杆菌污染事件发生后,肉毒杆菌及肉毒毒素受到了普遍关注。现就肉毒杆菌及肉毒毒素的生物学特性、中毒机制、诊断及治疗研究进展进行综述。%Bacillus botulinus is a deadly bacteria,can cause botulism disease by botulinum toxin which is among the most powerful known poisons. As an important risk factor for food safety,especially the in-cident of the product for Fonterra by botulinum toxin contamination was occured,Bacillus botulinus and botulinum toxin has been widespread concerned. The paper reviews the progress of biological characteris-tics,toxic mechanism,diagnosis and treatment for Bacillus botulinus and botulinum toxin.

  1. The combined effect of lower-limb multilevel botulinum toxin type A and comprehensive rehabilitation on mobility in children with cerebral palsy : A randomized clinical trial

    NARCIS (Netherlands)

    Scholtes, Vanessa A.; Dallmeijer, Annet J.; Knol, Dirk L.; Speth, Lucianne A.; Maathuis, Carel G.; Jongerius, Peter H.; Becher, Jules G.

    2006-01-01

    Objective: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). Design: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks aft

  2. The combined effect of lower-limb multilevel botulinum toxin type A and comprehensive rehabilitation on mobility in children with cerebral palsy: A randomized clinical trial

    NARCIS (Netherlands)

    Scholtes, V.A.; Dallmeijer, A.J.; Knol, D.L.; Speth, L.A.; Maathuis, C.G.; Jongerius, P.H.; Becher, J.G.

    2006-01-01

    Objective: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). Design: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks aft

  3. Toxin production of non-proteolytic Cl. botulinum type B in radurized fish. Part of a coordinated programme on the wholesomeness of the process of food irradiation

    International Nuclear Information System (INIS)

    Toxin formation by proteolytic and nonproteolytic strains of C. botulinum type B in radurized raw fish and in radurized Pindang fish was investigated. In radurized Pindang fish samples, inoculation was done either before or after cooking. Radurization process with 2 and 3 kGy caused the extension of storage life of Rastrelliger sp., Euthynnus sp., and Scomberomorus sp. by factors of 2 and 2.5 at storage temperatures between 5 and 100 C. In general at 10.5 +- 0.30 C, no toxin was formed before the samples were spoiled both in irradiated and unirradiated samples. At 5.6 +- 0.50 C no toxin was formed until after the samples were spoiled. The earliest toxin formation in unirradiated Pindang samples stored at ambient temperature was detected after the samples were spoiled. In irradiated Pindang samples inoculated with C. botulinum spores after cooking and stored at ambient temperature the toxin formation was detected before the samples were spoiled. However, if the inoculation was done before the fish was processed into Pindang, the toxin was always detected after the samples were spoiled regardless of the irradiation dose, strain and inoculation level. As fish may be contaminated - if at all - with spores of C. botulinum in its raw state, processing of fish into Pindang and irradiation would not contribute to the health hazard concerning botulism even if the samples are stored at ambient temperature

  4. Botulinum Toxin Type A for the Treatment of Neuropathic Pain in Neuro-Rehabilitation

    Directory of Open Access Journals (Sweden)

    Domenico Intiso

    2015-06-01

    Full Text Available Pain is a natural protective mechanism and has a warning function signaling imminent or actual tissue damage. Neuropathic pain (NP results from a dysfunction and derangement in the transmission and signal processing along the nervous system and it is a recognized disease in itself. The prevalence of NP is estimated to be between 6.9% and 10% in the general population. This condition can complicate the recovery from stroke, multiple sclerosis, spinal cord lesions, and several neuropathies promoting persistent disability and poor quality of life. Subjects suffering from NP describe it as burning, itching, lancing, and numbness, but hyperalgesia and allodynia represent the most bothersome symptoms. The management of NP is a clinical challenge and several non-pharmacological and pharmacological interventions have been proposed with variable benefits. Botulinum toxin (BTX as an adjunct to other interventions can be a useful therapeutic tool for the treatment of disabled people. Although BTX-A is predominantly used to reduce spasticity in a neuro-rehabilitation setting, it has been used in several painful conditions including disorders characterized by NP. The underlying pharmacological mechanisms that operate in reducing pain are still unclear and include blocking nociceptor transduction, the reduction of neurogenic inflammation by inhibiting neural substances and neurotransmitters, and the prevention of peripheral and central sensitization. Some neurological disorders requiring rehabilitative intervention can show neuropathic pain resistant to common analgesic treatment. This paper addresses the effect of BTX-A in treating NP that complicates frequent disorders of the central and peripheral nervous system such as spinal cord injury, post-stroke shoulder pain, and painful diabetic neuropathy, which are commonly managed in a rehabilitation setting. Furthermore, BTX-A has an effect in relief pain that may characterize less common neurological disorders

  5. Treatment of Chronic Migraine with Focus on Botulinum Neurotoxins

    Directory of Open Access Journals (Sweden)

    Sara M. Schaefer

    2015-07-01

    Full Text Available Migraine is the most common neurological disorder, and contributes to disability and large healthcare costs in the United States and the world. The treatment of migraine until recently has focused on medications, both abortive and prophylactic, but treatment of chronic migraine has been revolutionized with the introduction of botulinum toxin injection therapy. In this review, we explore the current understanding of migraine pathophysiology, and the evolution of the use of botulinum toxin therapy including proposed pathophysiological mechanisms through animal data. We also discuss the similarities and differences between three injection techniques.

  6. Treating glabellar lines with botulinum toxin type A-hemagglutinin complex: A review of the science, the clinical data, and patient satisfaction

    Directory of Open Access Journals (Sweden)

    Koenraad De Boulle

    2010-04-01

    Full Text Available Koenraad De Boulle1, Steven Fagien2, Boris Sommer3, Richard Glogau41Aalst Dermatology Clinic, Aalst, Belgium; 2Aesthetic Eyelid Plastic, Surgery, Boca Raton, FL, USA; 3Aesthetic Dermatology, Frankfurt, Germany; 4University of California, San Francisco, USAAbstract: Botulinum toxin type A treatment is the foundation of minimally invasive aesthetic facial procedures. Clinicians and their patients recognize the important role, both negative and positive, that facial expression, particularly the glabellar frown lines, plays in self-perception, emotional well-being, and perception by others. This article provides up-to-date information on fundamental properties and mechanisms of action of the major approved formulations of botulinum toxin type A, summarizes recent changes in naming conventions (nonproprietary names mandated by the United States Food and Drug Administration, and describes the reasons for these changes. The request for these changes provides recognition that formulations of botulinum toxins (eg, onabotulinumtoxinA and abobotulinumtoxinA are not interchangeable and that dosing recommendations cannot be based on any one single conversion ratio. The extensive safety, tolerability, and efficacy data are summarized in detail, including the patient-reported outcomes that contribute to overall patient satisfaction and probability treatment continuation. Based on this in-depth review, the authors conclude that botulinum toxin type A treatment remains a cornerstone of facial aesthetic treatments, and clinicians must realize that techniques and dosing from one formulation cannot be applied to others, that each patient should undergo a full aesthetic evaluation, and that products and procedures must be selected in the context of individual needs and goals.Keywords: onabotulinumtoxinA, botulinum toxin type A, cosmetic, glabellar, patient satisfaction

  7. A case report of the beneficial effects of botulinum toxin type A on Raynaud phenomenon in a patient with lung cancer

    Science.gov (United States)

    Wang, Lu; Lei, Qi-song; Liu, Yu-ying; Song, Guan-jie; Song, Chun-ling

    2016-01-01

    Abstract Objective: Raynaud phenomenon is a vasospastic disorder affecting the hands and feet, and the efficacies of traditional treatments, such as pharmacological therapies and sympathectomy, are not uniform. Patients with paraneoplastic Raynaud phenomenon do not benefit from the traditional treatments. The use of botulinum toxin type A (BTX-A) for Raynaud phenomenon has been reported for several years; however, there are few reports regarding botulinum toxin type A in the treatment of paraneoplastic Raynaud phenomenon. We describe a case report of the beneficial effects of botulinum toxin type A on Raynaud phenomenon in a patient with lung cancer. Methods: A 63-year-old male complained of pain and discoloration of his fingers and indicated that oral nifedipine and low-dose aspirin were not effective. After approximately 8 months, he was diagnosed with lung cancer. Chemotherapy partially reduced the pain and discoloration of his fingers; however, no significant changes occurred in his fingers after the fourth cycle. We used BTX-A to treat this patient with paraneoplastic RP. A visual analogue scale (VAS) was used to assess the clinical response. Results: After approximately 2 months, the patient reported relief from pain, stiffness, numbness, and cold sensation. Furthermore, no local or general adverse effects were exhibited by the patient. Conclusion: This study used botulinum toxin type A for a patient with paraneoplastic Raynaud phenomenon. Botulinum toxin type A significantly improved the patient's clinical symptoms without significant complications. These findings suggest that BTX-A may represent a good option for the treatment of paraneoplastic RP. PMID:27749585

  8. Inhibition of botulinum toxin's association with rat brain synaptosomes by toosendanin,an antibotulismic triterpenoid

    Institute of Scientific and Technical Information of China (English)

    Jianying Zhou; Yuliang Shi

    2006-01-01

    BACKGROUND:Toosendanin(TSN),a triterpenoid derivative extracted from the bark of Melia toosendanin Sieb et Zucc,has been demonstrated to be an effective drug for treatment of experimental botulism.OBJECTIVE:To explore its antibotulismic mechanism by observing the effect of toosendanin on association of botulinum toxin(BoTx)with rat brain synaptosomes under different conditions.DESIGN:A randomized controlled experiment.SETTING:Shanghai Institutes for Biological Sciences,Chinese Academy of Sciences.MATERIALS:Sprague-Dawley rats,weighing(220±12)g,were involved.TSN was a sample recrystallized in ethanol with a purity>98%.BoTx/A and BoTx/C of 500 ku(1.8x107mouse LD50/mg)were purchased from Wako(Japan),Horse antitoxins to BoTx/A and/C(pdmary antibodies)were purchased from Lanzhou Institute of Biological Products(China).METHODS:Major experiments were finished between March 2005 and October 2005 in key laboratory of neurobiology,Shanghai Institutes for Biological Sciences,Chinese Academy of Sciences.①Preparation of synaptosome of rats:one aliquot of synaptosome was pre-incubated with TSN(17μmol/L)for 20 minutes at 4℃or 37℃(another aliquot of synaptosome which was untouched was used as control).Then,BoTx was respectively added for another 20-minute incubation.②A homochronous experiment was still Derformed at 37℃.Differently,high level of K+ was used to stimulate synaptosome for 25 minutee.Two aliquots of synaptosomes with or without TSN(17 μmol/L)were preincubated for 15 minutes.Then,30 mmol/L KCl was separately added in two aliquots,5 minutes later,13 nmol/L BoTx/C was separately added followed by 20-minute incubation.[3]The effect of TSN on BoTx binding was observed by Western blot and synchronization method.③ttest was used for comparing the difference of measurement data.MAIN OUTCOME MEASURES:The gray value of BoTx bands from westem blot was used to estimate the bound amount of BoTx.RESULTS:①Preincubation of synaptosomes with TSN(17 μmol/L)at 4

  9. Altered cell metabolism in tissues of the knee joint in a rabbit model of Botulinum toxin A-induced quadriceps muscle weakness.

    Science.gov (United States)

    Leumann, A; Longino, D; Fortuna, R; Leonard, T; Vaz, M A; Hart, D A; Herzog, W

    2012-12-01

    Quadriceps muscle weakness is frequently associated with knee injuries in sports. The influence of quadriceps weakness on knee joint homeostasis remains undefined. We hypothesized that quadriceps weakness will lead to tissue-specific alterations in the cell metabolism of tissues of the knee. Quadriceps weakness was induced with repetitive injections of Botulinum toxin A in six 1-year-old New Zealand White rabbits for 6 months. Five additional animals served as controls with injections of saline/dextrose. Muscle weakness was assessed by muscle wet mass, isometric knee extensor torque, and histological morphology analysis. Cell metabolism was assessed for patellar tendon, medial and lateral collateral ligament, and medial and lateral meniscus by measuring the total RNA levels and specific mRNA levels for collagen I, collagen III, MMP-1, MMP-3, MMP-13, TGF-β, biglycan, IL-1, and bFGF by reverse transcription and polymerase chain reaction. While the total RNA levels did not change, tissue-specific mRNA levels were lower for relevant anabolic and catabolic molecules, indicating potential changes in tissue mechanical set points. Quadriceps weakness may lead to adaptations in knee joint tissue cell metabolism by altering a subset of anabolic and catabolic mRNA levels corresponding to a new functional and metabolic set point for the knee that may contribute to the high injury rate of athletes with muscle weakness.

  10. Effect of Fill Temperature on Clostridium botulinum Type A Toxin Activity during the Hot Filling of Juice Bottles.

    Science.gov (United States)

    Skinner, Guy E; Fleischman, Gregory J; Balster, Fran; Reineke, Karl; Reddy, N Rukma; Larkin, John W

    2015-08-01

    The potential threat of terrorist attacks against the United States food supply using neurotoxin produced by Clostridium botulinum (BoNT) has resulted in the need for studying the effect of various food process operations on the bioavailability of this toxin. The objective of this study was to evaluate C. botulinum type A neurotoxin bioavailability after a simulated hot fill juice bottling operation. C. botulinum type A acid mud toxin (∼10(6) mouse lethal dose [MLD50]/ml) was deposited into juice bottles at an experimentally determined fastest cooling spot. Bottles (12 or 20 oz [355 and 592 ml]) were filled with either apple juice or an orange drink, at 80 or 85°C, in either upright or inverted orientations. Toxicity of the juice was evaluated as a function of holding time (1 to 2 min) by the mouse bioassay. The fastest cooling point in the upright orientation was determined to be at a bottle's bottom rim. In the inverted orientation, the fastest cooling point was in the bottle cap region. With respect to these two points, the upright bottle cooled faster than the inverted bottle, which was reflected in a higher inactivation of BoNT in the latter. For the orange drink (pH 2.9) toxicity was reduced by 0.5 × 10(6) MLD50/ml to a nondetectable level after 1 min in all bottle sizes, orientations, and temperatures as measured by the mouse bioassay. This indicates that there was at least a 0.5 × 10(6) MLD50/ml reduction in activity. Inactivation in apple juice (pH 4.0), to the same degree as in the orange drink, was found only for the inverted orientation at 85°C. Complete inactivation in apple juice for all conditions was found at a lower added toxin level of 0.25 × 10(5) MLD50/ml. In general, bottle inversion and filling at 85°C provided complete inactivation of BoNT to the 0.5 × 10(6) MLD50/ml level. All experiments resulted in the inactivation of 2.5 × 10(4) MLD50/ml of BoNT regardless of juice type, fill temperature, or bottle orientation and size.

  11. Effect of Fill Temperature on Clostridium botulinum Type A Toxin Activity during the Hot Filling of Juice Bottles.

    Science.gov (United States)

    Skinner, Guy E; Fleischman, Gregory J; Balster, Fran; Reineke, Karl; Reddy, N Rukma; Larkin, John W

    2015-08-01

    The potential threat of terrorist attacks against the United States food supply using neurotoxin produced by Clostridium botulinum (BoNT) has resulted in the need for studying the effect of various food process operations on the bioavailability of this toxin. The objective of this study was to evaluate C. botulinum type A neurotoxin bioavailability after a simulated hot fill juice bottling operation. C. botulinum type A acid mud toxin (∼10(6) mouse lethal dose [MLD50]/ml) was deposited into juice bottles at an experimentally determined fastest cooling spot. Bottles (12 or 20 oz [355 and 592 ml]) were filled with either apple juice or an orange drink, at 80 or 85°C, in either upright or inverted orientations. Toxicity of the juice was evaluated as a function of holding time (1 to 2 min) by the mouse bioassay. The fastest cooling point in the upright orientation was determined to be at a bottle's bottom rim. In the inverted orientation, the fastest cooling point was in the bottle cap region. With respect to these two points, the upright bottle cooled faster than the inverted bottle, which was reflected in a higher inactivation of BoNT in the latter. For the orange drink (pH 2.9) toxicity was reduced by 0.5 × 10(6) MLD50/ml to a nondetectable level after 1 min in all bottle sizes, orientations, and temperatures as measured by the mouse bioassay. This indicates that there was at least a 0.5 × 10(6) MLD50/ml reduction in activity. Inactivation in apple juice (pH 4.0), to the same degree as in the orange drink, was found only for the inverted orientation at 85°C. Complete inactivation in apple juice for all conditions was found at a lower added toxin level of 0.25 × 10(5) MLD50/ml. In general, bottle inversion and filling at 85°C provided complete inactivation of BoNT to the 0.5 × 10(6) MLD50/ml level. All experiments resulted in the inactivation of 2.5 × 10(4) MLD50/ml of BoNT regardless of juice type, fill temperature, or bottle orientation and size. PMID

  12. Induction of an immune response by oral administration of recombinant botulinum toxin.

    OpenAIRE

    Kiyatkin, N; Maksymowych, A B; Simpson, L L

    1997-01-01

    A gene encoding the full-size botulinum neurotoxin serotype C was reconstructed in vector pQE-30 and expressed at high levels in Escherichia coli. Three amino acid mutations (H229-->G, E230-->T, and H233-->N) were generated in the zinc-binding motif, resulting in complete detoxification of the modified recombinant holotoxin. The PCR-amplified wild-type light chain of botulinum neurotoxin serotype C was also expressed in E. coli and used as a control in all experiments. Modified recombinant ho...

  13. [The efficacy of botulinum toxin therapy in patients with upper limb spasticity due to traumatic brain injury].

    Science.gov (United States)

    Akulov, M A; Khat'kova, S E; Mokienko, O A; Orlova, O R; Usachev, D Yu; Zakharov, V O; Orlova, A S; Tomsky, A A

    2016-01-01

    Spasticity is a type of muscle hyperactivity that occurs in patients after focal lesions of the Central nervous system due to various diseases: stroke, traumatic brain injury or spinal cord injury, neurosurgical intervention, as well as multiple sclerosis and other diseases of the Central nervous system and is the most disability manifestation of the syndrome of upper motor neuron (UMNS). Focal spasticity of the upper limb requires a complex treatment. Botulinum toxin therapy is an effective treatment for focal/multifocal spasticity in reducing muscle tone and improving function with the highest level of evidence according to the latest American and European guidelines for treatment of spasticity. There are many publications devoted to BTA use in post-stroke patients. This article provides a review of the BTA use in patients with the upper limb spasticity due to severe traumatic brain injury. Some local data on the BTA efficacy in the cohort of patients with traumatic brain injury are also presented. PMID:27635608

  14. Botulinum toxin has an increased effect when targeted toward the muscle's endplate zone: a high-density surface EMG guided study

    NARCIS (Netherlands)

    Lapatki, B.G.; Dijk, J.P. van; Warrenburg, B.P.C. van de; Zwarts, M.J.

    2011-01-01

    OBJECTIVES: To compare the effect of endplate-targeted injections of a low Botulinum neurotoxin type A (BoNT-A) dose with that of injections at defined distances from the motor endplate zone. METHODS: In eight healthy volunteers, the main endplate zones of the right and left extensor digitorum brevi

  15. Botulinum toxin for treatment of cocontractions related to obstetrical brachial plexopathy Toxina botulínica para tratamento das co-contrações relacionadas à plexopatia braquial obstétrica

    Directory of Open Access Journals (Sweden)

    Carlos O. Heise

    2005-09-01

    Full Text Available Botulinum toxin type A was recently introduced for treatment of biceps - triceps muscle cocontraction, which compromises elbow function in children with obstetrical brachial plexopathy. This is our preliminary experience with this new approach. Eight children were treated with 2 - 3 U/kg of botulinum toxin injected in the triceps (4 patients and biceps (4 patients muscle, divided in 2 or 3 sites. All patients submitted to triceps injections showed a long-lasting improvement of active elbow flexion and none required new injections, after a follow-up of 3 to 18 months. Three of the patients submitted to biceps injections showed some improvement of elbow extension, but none developed anti-gravitational strength for elbow extension and the effect lasted only three to five months. One patient showed no response to triceps injections. Our data suggest that botulinum toxin can be useful in some children that have persistent disability secondary to obstetrical brachial plexopathy.A toxina botulínica do tipo A foi introduzida recentemente para o tratamento das co-contrações entre os músculos biceps e triceps, que comprometem a função do cotovelo nas crianças com plexopatia braquial obstétrica. Apresentamos nossa experiência preliminar com esta abordagem. Oito crianças foram tratadas com 2 - 3 U/kg de toxina botulínica injetada nos músculos triceps (4 pacientes e biceps (4 pacientes, divididas em 2 ou 3 sítios. Todos os pacientes submetidos a injeções no triceps apresentaram melhora persistente da flexão do cotovelo e nenhum precisou de novas aplicações após seguimento de 3 a 18 meses. Três pacientes submetidos a aplicações no biceps apresentaram melhora na extensão do cotovelo, mas nenhum adquiriu força antigravitacional e o efeito durou apenas 3 a 5 meses. Um paciente não respondeu às injeções. Nossos dados sugerem que a toxina botulínica pode ser útil no tratamento de algumas crianças com seqüelas de plexopatia braquial

  16. Considerations on patient-related outcomes with the use of botulinum toxins: is switching products safe?

    Directory of Open Access Journals (Sweden)

    Fraint A

    2016-02-01

    Full Text Available Avram Fraint,1 Padmaja Vittal,2 Cynthia Comella2 1Department of Neurological Sciences, 2Section of Movement Disorders, Rush University Medical Center, Chicago, IL, USA Introduction: Botulinum toxin (BoNT is the treatment of choice for many neurologic movement disorders, including blepharospasm, hemifacial spasm, and cervical dystonia. There are two serotypes approved for use by the US Food and Drug Administration: three brands of serotype A and one of serotype B. Many attempts have been made at establishing dose conversion ratios between brands and serotypes. This review focuses on the existing data comparing different formulations of the same BoNT serotypes as well as that comparing different serotypes with one another. We focus on existing data regarding switching from one formulation or serotype to another and will also discuss the issue of immunogenicity of BoNT. With this information as a foundation, recommendations on safety of switching agents are addressed. Method: Literature review searching PubMed and Google Scholar using the search terms “switching botox”, “dosing equivalency in botox”, and “comparing botox”. Results/conclusion: Overall, there are many studies that demonstrate the efficacy and safety of each of the brands of BoNTs used in clinical practice. However, determination of dosing equivalencies among these brands and serotypes is complex with inconsistencies among the studies. When switching from one brand to another, the clinician should be aware of these issues, and not make the assumption that such ratios exist. Tailoring the dosage of each brand of BoNT to the clinical situation is the most prudent treatment strategy rather than focusing closely on conversion factors and concerns for immunogenicity. Keywords: botulinum toxin, BoNT, abobotulinumtoxin A, onabotulinumtoxin A, incobotulinumtoxin A, rimabotulinumtoxin B

  17. C型肉毒梭菌肉毒毒素的提取与鉴定%Extraction and Identification of Botulinum Toxins

    Institute of Scientific and Technical Information of China (English)

    薛正坤; 吴伟; 张晶; 李超毅; 吴辉; 李莲瑞

    2013-01-01

    [目的]通过对C型肉毒梭菌肉毒毒素的提取与鉴定,为类毒素和抗毒素的制备及抗原性分析奠定基础.[方法]将分离鉴定得到的C型肉毒梭菌通过扩大培养、产毒培养后将产生的肉毒毒素采用除菌过滤、硫酸铵盐盐析、离心、透析、浓缩的方法从产毒培养基中分离提取出来.再将提取的肉毒毒素通过SDS-PAGE鉴定毒素蛋白的分子量.[结果]分离出来的毒素蛋白重链和轻链分别在98和53 KDa左右,与C型肉毒毒素的理论分子量相符.[结论]提取的肉毒毒素是C型肉毒毒素.%[Objective] The project aims to lay a foundation for the preparation and antigenicity analysis of the toxoid and antitoxic through extraction and identification of the type C clostridium botulinumn. [Method] The separated and identified type C clostridium botulinum underwent expanding training, and after that, the procreant poison produced botulinum toxin through such methods as the aseptic filtration, ammonium sulfate salting separation, centrifugal treatment, dialysis and enrichment processes. Then the extracted toxin went through SDS - PAGE for its toxin protein molecular weight to be identified. [ Result ] From the experiments, the abstracted toxin protein heavy chain was about 98 KDA and light chain about 53 KDA, which was consistent with molecular weight of type C botulinum toxin theory. [ Conclusion] What we have extracted is C - type Clostridium botulinum.

  18. Tratamento da doença de Hailey-Hailey com toxina botulínica tipo A Hailey-Hailey disease treatment with Botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Giancarlo Rezende Bessa

    2010-10-01

    Full Text Available Duas irmãs com doença de Hailey-Hailey, com lesões recorrentes - uma em axilas e outra em região inguinal -, e resposta limitada aos tratamentos clássicos. Elas foram tratadas com aplicação de toxina botulínica tipo A. Observamos que houve importante melhora na paciente tratada na região inguinal e remissão completa na paciente em cujas axilas sofreram tratamento. Além disso, foi possível poupar uso de antibióticos sistêmicos e corticoides tópicos. O alto custo é um fator restritivo para uso rotineiro e estudos maiores são necessários para definir eficácia e relação custo-benefício dessa intervenção.Two sisters with recurrent lesions, one on axillae and other on the groin, and with limited response to classical treatments were treated with injections botulinum toxin type A. We observed marked improvement in the patient treated in the groin and complete remission in the patient treated in the axillae. It was possible to spare the use of systemic antibiotics and topical corticosteroids. The high cost is a restrictive factor to routine use and large studies are necessary to access efficacy and cost benefit profile.

  19. Distonia laríngea: relato de caso e tratamento com toxina botulínica Laryngeal dystonia: case report and treatment with botulinum toxin

    Directory of Open Access Journals (Sweden)

    Victor José Barbosa Santos

    2006-06-01

    Full Text Available Distonia laríngea, ou disfonia espasmódica, é caracterizada por contrações involuntárias e inapropriadas da musculatura responsável pela fonação, sendo a do tipo adutora a mais comum. Caracteriza-se por quebras fonatórias, sendo seu diagnóstico confirmado por videolaringoestroboscopia. O tratamento de escolha é feito com a aplicação direta de toxina botulínica nos músculos responsáveis pelo movimento incoordenado. O objetivo desse trabalho é relatar o caso de uma paciente com diagnóstico de distonia laríngea do tipo adutora, tratada com toxina botulínica e discutir as vantagens e observações descritas na literatura a respeito desse tratamento.Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and innapropiate spasms of vocal muscles, having the adductor type as the most common one. It is chacterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.

  20. A型肉毒毒素联合糖皮质激素治疗良性咬肌肥厚%Treatment of masseter hypertrophy with botulinum toxin type A and glucocorticoids

    Institute of Scientific and Technical Information of China (English)

    潘德玲; 袁继龙; 肖明

    2013-01-01

    Objective To investigate the clinical therapeutic effect of botulinum toxin type A and glu-cocorticoide on benign masseter hypertrophy.Methods Forty-seven cases ( 89 sides) with masseter hypertrophy were treated by the botulinum toxin type with 50 U per side and triamcinolone with 10 to 20 mg per side, the masseter thickness measured by CT and complications and adverse reactions were recorded at different time after injection.Results Compared with preoperative masseter thickness before injection, they was reduced significantly at different time after injection ( P<0.001).Totally 47 patients were satisfied with few complications.Conclusion Botulinum toxin type A and glucocorticoids injection is a safety, effective method for masseter hypertrophy.Prostecdtive efficacy should take a further observation.%目的 评价A型肉毒毒素联合糖皮质激素治疗良性咬肌肥大的疗效.方法 联合应用A型肉毒毒素和曲安奈德对47例(89侧)咬肌肥大求美者进行治疗,每一侧注射A型肉毒毒素剂量为50U、曲安奈德剂量为10~20mg,CT测量治疗前后不同时期求美者的咬肌厚度,记录不良反应和并发症.结果 在治疗后不同时期,47例(89侧)求美者的咬肌治疗区厚度均较治疗前减小(P <0.001),效果满意;47例均无严重并发症发生.结论 A型肉毒毒素联合糖皮质激素治疗咬肌肥大是一种安全有效的治疗方法,远期疗效尚需进一步观察.

  1. Crystal Structure of Botulinum Neurotoxin Type a in Complex With the Cell Surface Co-Receptor GT1b-Insight Into the Toxin-Neuron Interaction

    Energy Technology Data Exchange (ETDEWEB)

    Stenmark, P.; Dupuy, J.; Inamura, A.; Kiso, M.; Stevens, R.C.

    2009-05-26

    Botulinum neurotoxins have a very high affinity and specificity for their target cells requiring two different co-receptors located on the neuronal cell surface. Different toxin serotypes have different protein receptors; yet, most share a common ganglioside co-receptor, GT1b. We determined the crystal structure of the botulinum neurotoxin serotype A binding domain (residues 873-1297) alone and in complex with a GT1b analog at 1.7 A and 1.6 A, respectively. The ganglioside GT1b forms several key hydrogen bonds to conserved residues and binds in a shallow groove lined by Tryptophan 1266. GT1b binding does not induce any large structural changes in the toxin; therefore, it is unlikely that allosteric effects play a major role in the dual receptor recognition. Together with the previously published structures of botulinum neurotoxin serotype B in complex with its protein co-receptor, we can now generate a detailed model of botulinum neurotoxin's interaction with the neuronal cell surface. The two branches of the GT1b polysaccharide, together with the protein receptor site, impose strict geometric constraints on the mode of interaction with the membrane surface and strongly support a model where one end of the 100 A long translocation domain helix bundle swing into contact with the membrane, initiating the membrane anchoring event.

  2. Practical guidance for CD management involving treatment of botulinum toxin: a consensus statement

    OpenAIRE

    Albanese, Alberto; Abbruzzese, Giovanni; Dressler, Dirk; Duzynski, Wojciech; Khatkova, Svetlana; Marti, Maria-José; Mir, Pablo; Montecucco, Cesare; Moro, Elena; Pinter, Michaela; Relja, Maja; Roze, Emmanuel; Skogseid, Inger Marie; Timerbaeva, Sofiya; Tzoulis, Charalampos

    2015-01-01

    Cervical dystonia is a neurological movement disorder causing abnormal posture of the head. It may be accompanied by involuntary movements which are sometimes tremulous. The condition has marked effects on patients’ self-image, and adversely affects quality of life, social relationships and employment. Botulinum neurotoxin (BoNT) is the treatment of choice for CD and its efficacy and safety have been extensively studied in clinical trials. However, current guidelines do not provide enough pra...

  3. Striving for more good days: patient perspectives on botulinum toxin for the treatment of cervical dystonia

    OpenAIRE

    Taylor, Joanna; Poliziani,Michele; Liu, Xierong; Koch, Marco

    2016-01-01

    Michele Poliziani,1 Marco Koch,2 Xierong Liu1 1Opinion Health, London, UK; 2Merz Pharmaceuticals GmbH, Frankfurt am Main, Germany Background: The recommended reinjection interval for botulinum neurotoxin (BoNT) formulations in the treatment of cervical dystonia (CD) is generally ≥12 weeks, though intervals ≥10 weeks are approved for incobotulinumtoxinA in Europe. However, recurring symptoms can occur before the end of this period. Using qualitative research, we sought a greate...

  4. 康复训练及A型肉毒毒素注射治疗脑卒中下肢肌痉挛%Rehabilitation Training Combined with Botulinum Toxin A for Patients with Lower Limb Spasticity after Stroke

    Institute of Scientific and Technical Information of China (English)

    李巍巍; 杨坚; 张颖; 乔蕾; 范利

    2011-01-01

    目的:探讨康复训练结合A型肉毒毒素(BTX-A)注射对脑卒中后下肢肌痉挛患者肌张力、运动功能及步行能力的影响.方法:选择32例下肢伸肌痉挛,改良Ashworth痉挛量表(MAS)评定2~3级的脑卒中患者,随机分为综合组及对照组各16例.2组患者均对下肢痉挛肌群进行分点注射BTX-A.综合组在注射24 h后结合康复训练,包括神经发育技术、物理疗法及运动疗法等.2组治疗前后采用MAS评定下肢肌张力及Fugl-Meyer运动量表(FMA)评定下肢运动功能;并进行步速和步长测定.结果:BTX-A注射后1、6及12周时,2组患者MAS评分明显下降,FMA评分明显上升,步速和步长明显提高(均P<0.05).2组间比较,综合组表现更明显(P<0.05).结论:康复训练结合BTX-A注射可以显著降低脑卒中痉挛肢体的肌张力,提高运动功能和步行能力.%Objective: To investigate the effect of rehabilitation training combined with botulinum toxin A for patients with lower limb spasticity, movement dysfunction and disability to walk after stroke. Methods: Thirty-two patients with stroke were randomly divided into experimental group and control group, whose lower limb spasticity evaluated by Modified Ashworth Scale (MAS) was Ashworth level Ⅱ-level Ⅲ. The patients in experimental group received rehabilitation training combined with botulinum toxin A, and those in control group received injection of botulinum toxin A only. The patients in both two groups were separately subjected to the rehabilitation evaluation before, and 1st week, 6th week and 12th week after the injection of botulinum toxin A. The evaluation of MAS,Fugl-Meyer (FMA) movement function assessment and gait analysis were done. Results: The scores of MAS in experimental group were lower, and the scores of FMA & gait analysis were higher than in control group (P<0.05).Conclusion: Rehabilitation training combined with botulinum toxin A can reduce the extent of spasticity, and improve

  5. 研究应用A型肉毒毒素进行面部除皱的临床疗效%Clinical Efficacy of Application of Botulinum Toxin Type A on Facial Wrinkles

    Institute of Scientific and Technical Information of China (English)

    郜泽誉; 朱艳; 张志磊; 赵鹏

    2014-01-01

    目的:探讨和研究应用A型肉毒毒素进行面部除皱的临床治疗效果。方法:选取新疆医科大学第五附属医院2012年12月~2013年12月间接收的48例进行面部除皱的患者作为观察对象,对患者使用A型肉毒毒素进行注射治疗,每次使用A型肉毒毒素的总剂量不超过100U。结果:48例患者通过使用A型肉毒毒素注射之后,达到了很好的治疗效果,其中有46例患者的治疗效果显著有效,显著有效率为95.65%,治疗有效的为3例患者,有效率为6.25%,总有效率达到了100%。结论:使用A型肉毒毒素来去除面部的皱纹,其疗效非常显著,见效时间短,副作用小,患者的痛苦较少,是一种非常安全和有效的除皱方式,值得在临床上推广及应用。%Objective:To investigate the application and research of botulinum toxin type A in clinical treatment of facial wrinkles. Method:48 cases with facial wrinkles in the Fifth Affiliated Hospital of Xinjiang Medical University from December,2012 to December,2013 were regarded as research object. They were treated with botulinum toxin A injection. The total dose per use of botulinum toxin type A does not exceed 100U. Result:48 patients through the use of botulinum toxin type A injection achieved good therapeutic effect. The treatment effect of 46 cases was significantly effective,and the significant efficiency was 95.65%. 3 patients had effective treatment,the effective rate was 6.25%,the total effective rate was 100%. Conclusion:The effect of botulinum toxin type A is significant,the effective time is short,the side effect is little, and the pain of patients is less. So it is a very safe and effective anti wrinkle method,and worth application in clinical practice.

  6. Effects of Botulinum Toxin Type A on Cell Apoptosis in Rat Benign Prostatic Hyperplasia Model%A型肉毒毒素注射引起大鼠前列腺增生模型细胞凋亡的研究

    Institute of Scientific and Technical Information of China (English)

    杨雄; 杨栋; 侯腾; 马彦; 汪隆旺; 韩晓敏; 李兵; 陈朝晖

    2011-01-01

    目的:探讨A型肉毒毒素注射后前列腺的组织形态学变化.方法:建立SD大鼠前列腺增生模型,模型大鼠前列腺内分别注射不同剂量的A型肉毒毒素后,TUNEL检测前列腺细胞的凋亡,免疫组织化学技术检测对照组与10 U肉毒毒素注射组Bcl-2、Fas及Caspase-3的表达差异.结果:随着注射剂量的加大,大鼠前列腺体积及湿重出现明显下降,细胞凋亡增加.相比对照组,10U肉毒毒素注射组Bcl-2的表达下调而Fas及Caspase-3的表达上调.结论:A型肉毒毒素能有效的缩小前列腺体积,引起前列腺细胞的凋亡.%Objective:To investigate the morphological changes of rat prostate after the injection of Botulinum toxin type A. Methods: We established prostatic hyperplasia model of SD rats and injected different doses of botulinum toxin type A into the prostates of BPH rat model. Prostatic cells apoptosis was detected by TUNEL assay.The expression of Bcl-2、Fas, and Caspase-3 were evaluated as well. Results:In the botulinum toxin type A injection group, it was observed that the volume and wet weight of rat prostates were decreased, that cell apoptosis was increased. The expressions of Bcl-2, Fas, and Caspase-3 in 10U botulinum toxin injection group were different compared to the control group. Conclusions: Botulinum toxin type A can diminish the volume and wet weight of rat prostate and induce apoptosis of prostatic cells.

  7. 肉毒毒素引发一起食物中毒的检测%Detection of food poisoning caused by botulinum toxin

    Institute of Scientific and Technical Information of China (English)

    秦丽云; 李云; 王晓丽; 徐保红; 柳连顺; 吕国平

    2014-01-01

    目的 对因食入自制臭豆腐后,引起家庭内食物中毒的病因进行检测.方法 按中华人民共和国国家标准GB/T 4789·12-2003《食品卫生微生物学检验肉毒梭菌及肉毒毒素检验》方法,对食物中毒的样品用小白鼠进行肉毒毒素检测.结果 测定自制臭豆腐中存在B型肉毒毒素,毒力大致为1 000 ~ 10 000 MLD/ml的范围.结论 根据试验结果查明了中毒原因,为事故的调查提供了依据.%Objective The aim of this study was to investigate the cause of a food poisoning case in a family after consuming homemade stinky tofu.Methods The botulinum toxin was examined by mice virulence test according to GB/T 47890.12-2003 microbiological examination of food hygiene (examination of Clostridium botulinum and botulinum toxin).Results The type B botulinum toxin was identified in homemade stinky tofu,and the virulence of the toxin was approximately 1000-10000 MLD/g.Conclusion The cause of this food poisoning incidence was quickly identified by the test results,and the study provided the basis for investigating food poisoning.

  8. Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial

    OpenAIRE

    Sun, Shu-Fen; Hsu, Chien-Wei; Lin, Huey-Shyan; Chou, Yi-Jiun; Chen, Jun-yang; Wang, Jue-Long

    2014-01-01

    Background There was an increasing requirement for novel treatments of osteoarthritis (OA). The aim was to compare the efficacy of intraarticular Botulinum toxin type A (BoNT-A) and intraarticular hyaluronate plus rehabilitation exercise in patients with ankle OA. Methods This was a prospective, randomized, assessor-blinded study with a 6-month follow-up period, conducted in the outpatient rehabilitation department at a university-affiliated tertiary care medical center. Seventy-five patients...

  9. Botulinum toxin-induced facial muscle paralysis affects amygdala responses to the perception of emotional expressions: preliminary findings from an A-B-A design

    OpenAIRE

    Kim, M. Justin; Neta, Maital; Davis, F. Caroline; Ruberry, Erika J.; Dinescu, Diana; Heatherton, Todd F.; Stotland, Mitchell A; Whalen, Paul J.

    2014-01-01

    Background It has long been suggested that feedback signals from facial muscles influence emotional experience. The recent surge in use of botulinum toxin (BTX) to induce temporary muscle paralysis offers a unique opportunity to directly test this “facial feedback hypothesis.” Previous research shows that the lack of facial muscle feedback due to BTX-induced paralysis influences subjective reports of emotional experience, as well as brain activity associated with the imitation of emotional fa...

  10. 肉毒素对面神经显微血管减压术中电生理监测侧方扩散的影响%Effects of botulinum toxin on electrophysiological monitoring the lateral spread response in the facial nerve microvascular decompression surgery

    Institute of Scientific and Technical Information of China (English)

    黄凯敏; 张勇; 张阳; 林劲芝; 胡燕霞

    2016-01-01

    目的 探讨面肌痉挛患者面部注射肉毒素治疗后,对显微血管减压术中神经电生理监测指标侧方扩散(LSR)的影响.方法 回顾性研究广东省第二人民医院神经外科2013年7月至2014年12月,行显微血管减压术的面肌痉挛患者90例.根据手术前有无注射过肉毒素分为肉毒素组(18例)和非肉毒素组(72例).观察肉毒素对术中LSR变化的影响及LSR变化对预后评估的作用.结果 肉毒素组颧支LSR潜伏期平均为(11.4 ±2.1)ms,非肉毒素组为(9.3±1.4)ms,差异有统计学意义(P<0.05).肉毒素组下颌支LSR潜伏期为(8.9±1.7)ms,非肉毒素组为(8.2±1.4)ms(P>0.05).肉毒素组颧支LSR波幅为(116.1 ±61.1)μV,下颌支为(116.1±54.5)μV;非肉毒素组颧支为(125.5 ±55.8) μV,下颌支为(125.9± 52.1) μV,两组差异均无统计学意义(P>0.05).置入垫片后,肉毒素组颧支、下颌支LSR消失比例分别为16/18、17/18;非肉毒素组颧支消失率为90%(65/72),下颌支为96%(69/72),两组差异均无统计学意义(P>0.05).肉毒素组颧支LSR消失对预后判断的灵敏度为94%(15/16),非肉毒素组为98%(64/65),差异有统计学意义(P<0.05).肉毒素组下颌支LSR及颧支和下颌支两支LSR同时消失对预后判断的灵敏度分别为94%(16/17)、94%(15/16);非肉毒素组的分别为93%(64/69)、97% (59/61),两组差异均无统计学意义(P>0.05).结论 肉毒素对术中LSR有影响,表现为颧支LSR潜伏期延长;下颌支或联合颧支LSR监测的方式,优于单纯监测颧支LSR.%Objective To investigate the effects of facial injecting botulinum toxin on electrophysiological monitoring indicator lateral spread response (LSR) in patients with hemifacial spasm in microvascular decompression surgery.Methods Ninety patients with facial spasm underwent microvascular decompression surgery in Guangdong No 2 Provincial People' s Hospital from July 2013 to December 2014 were enrolled retrospectively

  11. A型肉毒毒素治疗Meige综合征的方法及效果分析%Botulinum toxin type A treatment of Meige syndrome of the method and result analysis

    Institute of Scientific and Technical Information of China (English)

    汪健; 高平峰; 周发明; 席刚明

    2011-01-01

    Objective Discusses botulinum toxin type A treatment of Meige syndrome the method and the effect.Methods 47 patients under the guidance of the EMG needle electrode with a double as the syringe,Spasm sites in patients with botulinum toxin type A intramuscular injection,each injected volume 0.1 ~0.2mi (including botulinum toxin 2.5~5U),number of injection points to 8 points points.According to Cohen,Albert spasm intensity grading evaluation curative effect.Results After the injection,the general 3~4days of effect,the curative effect continued for 3~6 months,the recrudescence duplicate injection was still effective,After the treatment,the patient myospasm intensity obvious drop, the comparison has the extremely significance difference before the treatment (P<0.01).The symptom alleviates and the obvious alleviation completely reaches 89.4% ,around the treatment the curative effect comparison has the extremely significance difference (P<0.01).Adverse reactions are mainly: local edema,bite muscle weakness,ptosis and so on,generally all can recover within two weeks.Conclusions Local injection of botulinum toxin type A treatment of Meige syndrome is a safe and effective and feasible treatment.%目的:探讨A型肉毒毒素治疗Meige综合征的方法及疗效.方法:47例患者在肌电图引导下用兼作注射器的针电极进行,在患者肌痉挛部位用A型肉毒毒素肌肉内注射,每点注射量为0.1~0.2ml(含肉毒毒素2.5~5 U),注射点数为数点~8点.根据Cohen、Albert痉挛强度分级评估疗效.结果:注射后一般3~4天起效,疗效持续3~6个月,复发者重复注射仍有效.治疗后患者肌痉挛强度明显下降,与治疗前比较有极显著性差异(P<0.01);症状完全缓解和明显缓解者达89.4%,治疗前后疗效比较有极显著性差异(P<0.01).不良反应主要有:局部水肿、咬肌无力、眼睑下垂等,一般两周内均能恢复.结论:局部注射A型肉毒毒素治疗Meige综合征为

  12. Laboratory diagnosis of botulinum toxin E poisoning%一起E型肉毒毒素中毒的实验室诊断

    Institute of Scientific and Technical Information of China (English)

    焦焱; 汪春翔; 葛华; 来身德

    2011-01-01

    Objective To detect the botulinum toxin in poisoned food, in order to guide the emergency treatment Method According to the method of CB/T4789.12 - 2003, it was Food Hygiene Microbiology in Examination of Clostridium Botulinum and Botuliruis Toxin, selecting the samples from poisoned food, and than tested by toxicity test Results Botulinum toxin type E existed in poisoned food. Conclusions By the test, we can clear and definite the poisoning reason quickly and provided evidences for timely accurate treatment.%目的检测中毒食品中的肉毒毒素,以指导救治。方法按中华人民共和国国家标准GB/T4789. 12-2003(食品卫生微生物学检验肉毒梭菌及肉毒毒素检验),用采集的食物中毒样品对小白鼠进行毒力检测。结果中毒食品中检出E型肉毒毒素。结论根据试验结果很快查明中毒原因,为及时救治中毒患者提供了强有力的依据。

  13. Intradetrusorial Botulinum Toxin in Patients with Multiple Sclerosis: A Neurophysiological Study.

    Science.gov (United States)

    Conte, Antonella; Giannantoni, Antonella; Gubbiotti, Marilena; Pontecorvo, Simona; Millefiorini, Enrico; Francia, Ada; Porena, Massimo; Berardelli, Alfredo

    2015-08-26

    Patients with multiple sclerosis (MS) often complain of urinary disturbances characterized by overactive bladder syndrome and difficulties in bladder emptying. The aim of the study was to investigate the pathophysiology of bladder dysfunction and the neurophysiological effects of intradetrusorial incobotulinum toxin A (BoNT/A) in patients with MS having both brain and spinal MS-related lesions. Twenty-five MS patients with neurogenic detrusor overactivity (NDO) underwent clinical evaluation and soleus Hoffmann reflex (H reflex) study during urodynamics. Of the 25 patients, 14 underwent a further session one month after intradetrusorial BoNT/A injection. Eighteen healthy subjects acted as the control. In healthy subjects, the H reflex size significantly decreased at maximum cystometric capacity (MCC), whereas in MS patients with NDO, the H reflex remained unchanged. In the patients who received intradetrusorial BoNT/A, clinical and urodynamic investigations showed that NDO improved significantly. Volumes at the first, normal and strong desire to void and MCC increased significantly. Despite its efficacy in improving bladder symptoms and in increasing volumes for first desire, normal and strong desire to void, BoNT/A left the H reflex modulation during bladder filling unchanged. In the MS patients we studied having both brain and spinal MS-related lesions, the H reflex size remained unchanged at maximum bladder filling. Since this neurophysiological pattern has been previously found in patients with spinal cord injury, we suggest that bladder dysfunction arises from the MS-related spinal lesions. BoNT/A improves bladder dysfunction by changing bladder afferent input, as shown by urodynamic findings on bladder filling sensations, but its effects on H reflex modulation remain undetectable.

  14. Phospholipase C Produced by Clostridium botulinum Types C and D:Comparison of Gene, Enzymatic, and Biological Activities with Those of Clostridium perfringens Alpha-toxin

    Directory of Open Access Journals (Sweden)

    Sakurai,Jun

    2013-02-01

    Full Text Available Clostridium botulinum type C and D strains recently have been found to produce PLC on egg yolk agar plates. To characterize the gene, enzymatic and biological activities of C. botulinum PLCs (Cb-PLCs, the cb-plc genes from 8 strains were sequenced, and 1 representative gene was cloned and expressed as a recombinant protein. The enzymatic and hemolytic activities of the recombinant Cb-PLC were measured and compared with those of the Clostridium perfringens alpha-toxin. Each of the eight cb-plc genes encoded a 399 amino acid residue protein preceded by a 27 residue signal peptide. The protein consists of 2 domains, the N- and C-domains, and the overall amino acid sequence identity between Cb-PLC and alpha-toxin was greater than 50%, suggesting that Cb-PLC is homologous to the alpha-toxin. The key residues in the N-domain were conserved, whereas those in the C-domain which are important in membrane interaction were different than in the alpha-toxin. As expected, Cb-PLC could hydrolyze egg yolk phospholipid, p-nitrophenylphosphorylcholine, and sphingomyelin, and also exhibited hemolytic activity;however, its activities were about 4- to over 200-fold lower than those of alpha-toxin. Although Cb-PLC showed weak enzymatic and biological activities, it is speculated that Cb-PLC might play a role in the pathogenicity of botulism or for bacterial survival.

  15. Studies on growth and toxin production of C. botulinum type E on cod homogenate treated with a combination of spices, sodium chloride and gamma-radiation

    Energy Technology Data Exchange (ETDEWEB)

    Siddiqui, A.K. (Atomic Energy Centre, Dacca (Bangladesh)); Ando, Y.; Karashimada, T.; Kameyama, K.

    1979-09-01

    Cod homogenates inoculated with spores of C. botulinum type E strain Erimo at 10/sup 2/ and 10/sup 4//g were treated with 1% and 2% sodium chloride, 0.25% each of mustard, garlic and turmeric and 0.3 Mrad ..gamma..-radiation either in single or combination treatments. The growth and toxin production of type E spores in the inoculated homogenates were followed at incubation temperatures of 30/sup 0/, 10/sup 0/ and 5/sup 0/C for 7, 28 and 56 days respectively. Growth and gas formation were noted in all the samples but type E toxin could not be detected. The reason for the absence of toxin in both the untreated and treated homogenates could not be ascertained. Inadequate detection method, unfavourable growth conditions in the homogenate and weak toxigenicity of the strain employed have been advanced as probable factors that contributed to the negative results on the toxin assay.

  16. Effect of initial O2 and CO2 and low-dose irradiation on toxin production by Clostridium botulinum in MAP fresh pork

    International Nuclear Information System (INIS)

    The effects of irradiation, initial O2, initial CO2 and the presence of an O2 and CO2 absorbent on toxin production by Clostridium botulinum in inoculated pork stored at 15 degrees C were studied using a factorial experiment. Toxin production occurred faster in samples initially packaged with 20% O2, compared to samples packaged with 100% N2. The presence of CO2 in the package headspace was not a significant factor affecting time until toxin detection. Irradiation was significant in delaying the time until toxin detection in samples initially packaged with 20% O2 but not in other treatments. Sensory rejection, based primarily on discoloration, occurred within 7 to 14 d, irrespective of treatment. All samples were spoiled before they became toxic

  17. Avaliação do filme lacrimal de pacientes com distonia facial durante tratamento com toxina botulínica tipo A Lacrimal film evaluation of patients with facial dystonia during botulinum toxin type A treatment

    Directory of Open Access Journals (Sweden)

    Patricia Grativol Costa

    2006-06-01

    Full Text Available OBJETIVO: Determinar o efeito da toxina botulínica no filme lacrimal em pacientes com distonia facial. MÉTODOS: Foram incluídos 24 pacientes portadores de blefaroespasmo essencial e espasmo hemifacial que receberam aplicação de toxina botulínica tipo A que foram submetidos à propedêutica do filme lacrimal previamente à aplicação e após, com 7 e 30 dias. RESULTADOS: Houve diminuição das queixas de olho seco trinta dias após a aplicação, entretanto, o tempo de ruptura do filme lacrimal e o teste de Schirmer não demonstraram variação significativa entre os períodos pré-tratamento e 1 mês da aplicação. Em relação ao teste de coloração com rosa bengala, todos os olhos que coraram no pré-tratamento, melhoraram na última avaliação. CONCLUSÃO: A injeção de toxina botulínica pode aliviar as queixas de olho seco nos pacientes com distonia facial pela provável ação de inibição do orbicular na sua função de bomba lacrimal.PURPOSE: To determine the effect of botulinum toxin injection in the eyelid on lacrimal film in patients with facial dystonia. METHODS: Twenty-four patients with essential blepharospasm and hemifacial spasm were submitted to botulinum toxin injection and lacrimal film tests were performed before the application and after seven and thirty days. RESULTS: There was improvement in symptoms of dry eye and rose bengal test, however, the breakup time and Schirmer's test did not show significant variation between pretreatment and after 1 month of follow-up. CONCLUSION: The dry eye symptoms in patients with facial dystonia may be attenuated by botulinum toxin due to its possible inhibitory effect on the orbicular muscle leading to a decrease in lacrimal pump.

  18. Efecto protector de la toxina botulínica en colgajos cutáneos The protective effect of botulinum toxin on skin flaps

    Directory of Open Access Journals (Sweden)

    C.X. Astudillo Carrera

    2011-06-01

    Full Text Available Los colgajos cutáneos de patrón vascular randomizado son de gran utilidad en Cirugía Reconstructiva; un aporte vascular adecuado es el factor más importante para la supervivencia de los mismos. Realizamos un estudio experimental levantando un total de 36 colgajos en el dorso de 9 conejos (4 en cada conejo: a 9 controles, b 9 con aplicación de toxina botulínica tipo A transoperatoria a lo largo del colgajo, c 9 con toxina botulínica tipo A aplicada 7 días antes del procedimiento quirúrgico, y, d 9 con aplicación de toxina botulínica tipo A transoperatoria más epinefrina. El análisis de los colgajos se realizó a través de imágenes digitales que se examinaron con el programa ImageJ. Efectuamos el análisis estadístico con la prueba T de Student. La evaluación final de los colgajos se realizó al séptimo día, tiempo en el cual se obtuvo: a una media de área necrótica en los controles del 72.17 ± 3.9% ; b en los que se aplicó toxina botulínica transoperatoria el porcentaje de aérea necrótica fue del 5.09 ± 1.2% p = 0.032; c en aquellos en los que la toxina botulínica se aplicó 7 días antes del procedimiento se reportó necrosis del 24.97 ± 2.7% p = 0.041 y d en los que se aplicó toxina botulínica transoperatoria más epinefrina el porcentaje de necrosis fue del 23.90 ± 3.9% p = 0.045. Concluimos que la toxina botulínica tipo A actúa como protector contra el proceso de sufrimiento-isquemia de los tejidos, debido a su acción vasodilatadora, recomendando su aplicación al inicio del procedimiento quirúrgico.Random-pattern cutaneous flaps are very useful in Reconstructive Surgery; an adequate vascular contribution is an important factor for the survival of the flaps. We designed an experimental study elevating a total of 36 dorsal flaps, divided in 4 groups: a 9 were controls, to which 0.9% physiological solution was applied, b 9 with a transoperatory application of type A botulinum toxin throughout the length of

  19. Effectiveness of resistance training in combination with botulinum toxin-A on hand and arm use in children with cerebral palsy: a pre-post intervention study

    Directory of Open Access Journals (Sweden)

    Elvrum Ann-Kristin G

    2012-07-01

    Full Text Available Abstract Background The aim of this pilot study was to examine the effects of additional resistance training after use of Botulinum Toxin-A (BoNT-A on the upper limbs in children with cerebral palsy (CP. Methods Ten children with CP (9–17 years with unilaterally affected upper limbs according to Manual Ability Classification System II were assigned to two intervention groups. One group received BoNT-A treatment (group B, the other BoNT-A plus eight weeks resistance training (group BT. Hand and arm use were evaluated by means of the Melbourne assessment of unilateral upper limb function (Melbourne and Assisting Hand Assessment (AHA. Measures of muscle strength, muscle tone, and active range of motion were used to assess neuromuscular body function. Measurements were performed before and two and five months after intervention start. Change scores and differences between the groups in such scores were subjected to Mann–Whitney U and Wilcoxon Signed Rank tests, respectively. Results Both groups had very small improvements in AHA and Melbourne two months after BoNT-A injections, without differences between groups. There were significant, or close to significant, short-term treatment effects in favour of group BT for muscle strength in injected muscles (elbow flexion strength, p = .08 and non-injected muscles (elbow extension and supination strength, both p = .05, without concomitant increases in muscle tone. Active supination range improved in both groups, but more so in group BT (p = .09. There were no differences between the groups five months after intervention start. Conclusions Resistance training strengthens non-injected muscles temporarily and may reduce short-term strength loss that results from BoNT-A injections without increasing muscle tone. Moreover, additional resistance training may increase active range of motion to a greater extent than BoNT-A alone. None of the improvements in neuromuscular impairments further

  20. A Review of Thoracic Outlet Syndrome and the Possible Role of Botulinum Toxin in the Treatment of This Syndrome

    Directory of Open Access Journals (Sweden)

    Andrew Travlos

    2012-11-01

    Full Text Available The objective of this paper is to discuss the classification, diagnosis, pathophysiology and management of Thoracic outlet syndrome (TOS. Thoracic outlet syndrome (TOS is a complex entity that is characterized by different neurovascular signs and symptoms involving the upper limb. TOS is defined as upper extremity symptoms due to compression of the neurovascular bundle in the area of the neck just above the first rib. Compression is thought to occur at one or more of the three anatomical compartments: the interscalene triangle, the costoclavicular space and the retropectoralis minor spaces. The clinical presentation can include both neurogenic and vascular symptoms. TOS can be difficult to diagnose because there is no standardized objective test that can be used and the clinician must rely on history and several positive findings on physical exam. The medial antebrachial cutaneous nerve conduction may be a sensitive way to detect pathology in the lower trunks of the brachial plexus which is promising for future research. Treatment options continue to be conservative and surgical. However, for those who have failed physical therapy there is research to suggest that botulinum toxin may help with symptom relief. However, given that there has been conflicting evidence, further research is required using randomized controlled trials.

  1. Clostridium botulinum Toxin Production in Relation to Spoilage of Atlantic Salmon (Salmo salar) Packaged in Films of Varying Oxygen Permeabilities and with Different Atmospheres.

    Science.gov (United States)

    Erickson, Marilyn C; Ma, Li M; Doyle, Michael P

    2015-11-01

    Shelf life of fish packaged under modified atmosphere (MA) is extended, but within the United States, commercial application of MA with impermeable packaging films is restricted due to concerns that botulinum toxin production would precede spoilage when contaminated fish are held at abusive storage temperatures. Use of semipermeable packaging films has been advocated; however, previous studies are inconclusive in determining the oxygen transmission rate (OTR) of a film that is needed to achieve an acceptable margin of safety (i.e., toxin production occurs only after spoilage). This study was conducted to determine the influence of OTR (target OTRs of 3 to 15,000) on the development of spoilage volatiles and toxin in salmon inoculated with type E Clostridium botulinum and subjected to air, vacuum, or 75:25 CO2:N2 MA and storage temperatures of 4, 8, 12, or 16°C. The most dominant headspace volatile peak that was produced during spoilage of samples at 4, 8 or 12°C was a peak, having a Kovats retention index (KI) of 753, and at which external standards of 2- or 3-methyl 1-butanol also eluted. Under anaerobic conditions, both the aerobic microbial populations and the size of the KI 753 spoilage peak were less in inoculated samples compared with uninoculated samples. C. botulinum-inoculated samples that were stored at 12 or 16°C under conditions favorable for anaerobic growth were also characterized by a KI 688 peak. Using a previously developed model that related the percentage of elderly consumers who would prepare a sample having the KI 753 spoilage peak of a specific size, it was determined that for salmon packaged with 3 or 3,000 OTR films under any atmosphere and stored at 12 or 16°C, 2 to 61% of the consumers could potentially prepare toxin-contaminated samples. Hence, when abusive storage conditions are suspected, the fish should not be consumed.

  2. Growth and formation of toxin by Clostridium botulinum in peeled, inoculated, vacuum-packed potatoes after a double pasteurization and storage at 25 degrees C.

    Science.gov (United States)

    Lund, B M; Graham, A F; George, S M

    1988-03-01

    A process that claims to use a double pasteurization to produce vacuum-packed potatoes for storage at ambient temperature has been evaluated. After the first pasteurization, potatoes are vacuum-packed and stored at 25 degrees-35 degrees C for up to 24 h, which is intended to allow germination of bacterial spores, and are then pasteurized again. When potatoes were inoculated with spores of Clostridium botulinum and subjected to this double-pasteurization process a high proportion of spores remained viable and resulted in growth and formation of toxin within 5-9 d at 25 degrees C. To provide an appropriate reduction in the risk o survival and growth of Cl. botulinum, peeled, vacuum-packed potatoes for storage at ambient temperature should be given a heat treatment equivalent to an F(0)3 process. If they are not given such a heat treatment they should be stored at a temperature below 4 degrees C.

  3. Practical guidance for CD management involving treatment of botulinum toxin: a consensus statement.

    Science.gov (United States)

    Albanese, Alberto; Abbruzzese, Giovanni; Dressler, Dirk; Duzynski, Wojciech; Khatkova, Svetlana; Marti, Maria Jose; Mir, Pablo; Montecucco, Cesare; Moro, Elena; Pinter, Michaela; Relja, Maja; Roze, Emmanuel; Skogseid, Inger Marie; Timerbaeva, Sofiya; Tzoulis, Charalampos

    2015-10-01

    Cervical dystonia is a neurological movement disorder causing abnormal posture of the head. It may be accompanied by involuntary movements which are sometimes tremulous. The condition has marked effects on patients' self-image, and adversely affects quality of life, social relationships and employment. Botulinum neurotoxin (BoNT) is the treatment of choice for CD and its efficacy and safety have been extensively studied in clinical trials. However, current guidelines do not provide enough practical information for physicians who wish to use this valuable treatment in a real-life setting. In addition, patients and physicians may have different perceptions of what successful treatment outcomes should be. Consequently, an international group of expert neurologists, experienced in BoNT treatment, met to review the literature and pool their extensive clinical experience to give practical guidance about treatment of CD with BoNT. Eight topic headings were considered: the place of BoNT within CD treatment options; patient perspectives and desires for treatment; assessment and goal setting; starting treatment with BoNT-A; follow-up sessions; management of side effects; management of non-response; switching between different BoNT products. One rapporteur took responsibility for summarising the current literature for each topic, while the consensus statements were developed by the entire expert group. These statements are presented here along with a discussion of the background information. PMID:25877834

  4. Application of botulinum toxin in the department of dermatology and pain medicine%肉毒毒素在皮肤科及疼痛科领域的应用

    Institute of Scientific and Technical Information of China (English)

    张燕; 刘桂丽; 林元珠

    2015-01-01

    Botulinum toxin is a neurotoxin derived from clostridium botulinum.It has been widely used in the treatment of neuromuscular diseases.With the research and application of botulinum toxin,botulinum toxin type A has been used with a great program in the department of dermatology and pain medicine.In this article,the advances of the botulinum toxin in the above two fields are reviewed.%肉毒毒素是肉毒杆菌产生的一种强烈神经毒素,已广泛应用于神经肌肉等疾病的治疗.随着人们对肉毒毒素的研究及应用,A型肉毒毒素在皮肤科和疼痛科领域的应用也有了长足的进展.本文概述了肉毒毒素在皮肤科及疼痛科领域的研究及应用的新进展.

  5. Clinical practice of botulinum toxin treatment in oral and maxillofacial field%肉毒素注射治疗在颌面部的临床应用

    Institute of Scientific and Technical Information of China (English)

    谢窈; 傅开元

    2010-01-01

    @@ 肉毒素(botulinum toxin,BTX)是肉毒梭状芽胞杆菌(简称:肉毒梭菌)生长和繁殖过程中产生的一种细菌外毒素,根据毒素抗原的不同分7型,即A、B、C、D、E、F、G.A、B、E、F是人中毒的主要型别,可引起20%~40%的病死率~([1]).

  6. Efficacy of Long-term Effect and Repeat Intraarticular Botulinum toxin in Patients with Painful Total Joint Arthroplasty: A Retrospective Study

    OpenAIRE

    Singh, Jasvinder A

    2014-01-01

    Objective Based on recent success of intra-articular (IA) Botulinum neurotoxin type A (BoNT/A; OnabotulinumtoxinA) in patients with osteoarthritis, we examined if repeat IA-BoNT/A is an effective antinociceptive in patients with refractory arthroplasty pain. Methods 11 patients with refractory chronic arthroplasty joint pain without any evidence of infection or prosthesis loosening were referred by orthopedic surgeons. After discussion of off-label use, each patient underwent IA injection of ...

  7. No Decrease in Muscle Strength after Botulinum Neurotoxin-A Injection in Children with Cerebral Palsy

    Science.gov (United States)

    Eek, Meta N.; Himmelmann, Kate

    2016-01-01

    Spasticity and muscle weakness is common in children with cerebral palsy (CP). Spasticity can be treated with botulinum neurotoxin-A (BoNT-A), but this drug has also been reported to induce muscle weakness. Our purpose was to describe the effect on muscle strength in the lower extremities after BoNT-A injections in children with CP. A secondary aim was to relate the effect of BoNT-A to gait pattern and range of motion. Twenty children with spastic CP were included in the study, 8 girls and 12 boys (mean age 7.7 years). All were able to walk without support, but with increased muscle tone interfering with motor function and gait pattern. Sixteen children had unilateral spastic CP and four bilateral spastic CP. Twenty-four legs received injections with BoNT-A in the plantar flexor muscles. The children were tested before treatment, around 6 weeks after at the peak effect of BoNT-A, and at 6 months after treatment, with measurement of muscle strength, gait analysis, and range of motion. There were no differences in muscle strength in plantar flexors of treated legs at peak effect compared to baseline. Six months after treatment, there was still no change in untreated plantar flexor muscles, but an increasing trend in plantar flexor strength in legs treated with BoNT-A. Parents reported positive effects in all children, graded as: small in three children, moderate in eight, and large in nine children. The gait analysis showed a small improvement in knee extension at initial contact, and there was a small increase in passive range of motion for ankle dorsiflexion. Two children had a period with transient weakness and pain. We found that voluntary force production in plantar flexor muscles did not decrease after BoNT-A, instead there was a trend to increased muscle strength at follow-up. The increase may be explained as an effect of the blocking of involuntary nerve impulses, leading to an opportunity to using and training the muscles with voluntary control. Adequate

  8. Literature Review and Comparison of Two Statistical Methods to Evaluate the Effect of Botulinum Toxin Treatment on Gait in Children with Cerebral Palsy

    Science.gov (United States)

    Nieuwenhuys, Angela; Papageorgiou, Eirini; Pataky, Todd; De Laet, Tinne; Molenaers, Guy; Desloovere, Kaat

    2016-01-01

    Aim This study aimed at comparing two statistical approaches to analyze the effect of Botulinum Toxin A (BTX-A) treatment on gait in children with a diagnosis of spastic cerebral palsy (CP), based on three-dimensional gait analysis (3DGA) data. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized. Methods Part 1—Intervention studies on BTX-A treatment in children with CP between 4–18 years that used 3DGA data as an outcome measure and were written in English, were identified through a broad systematic literature search. Reported kinematic and kinetic gait features were extracted from the identified studies. Part 2—A retrospective sample of 53 children with CP (6.1 ± 2.3years, GMFCS I-III) received 3DGA before and after multilevel BTX-A injections. The effect of BTX-A on gait was interpreted by comparing the results of paired samples t-tests on the kinematic gait features that were identified from literature to the results of statistical parametric mapping analysis on the kinematic waveforms of the lower limb joints. Results Part 1–53 kinematic and 33 kinetic features were described in literature. Overall, there is no consensus on which features should be evaluated after BTX-A treatment as 49 features were reported only once or twice. Part 2—Post-BTX-A, both statistical approaches found increased ankle dorsiflexion throughout the gait cycle. Statistical parametric mapping analyses additionally found increased knee extension during terminal stance. In turn, feature analyses found increased outtoeing during stance after BTX-A. Conclusion This study confirms that BTX-A injections are a valuable treatment option to improve gait function in children with CP. However, different statistical approaches may lead to different interpretations of treatment outcome. We suggest that a clear, definite hypothesis should be stated a priori and a commensurate statistical approach should

  9. Literature Review and Comparison of Two Statistical Methods to Evaluate the Effect of Botulinum Toxin Treatment on Gait in Children with Cerebral Palsy.

    Directory of Open Access Journals (Sweden)

    Angela Nieuwenhuys

    Full Text Available This study aimed at comparing two statistical approaches to analyze the effect of Botulinum Toxin A (BTX-A treatment on gait in children with a diagnosis of spastic cerebral palsy (CP, based on three-dimensional gait analysis (3DGA data. Through a literature review, the available expert knowledge on gait changes after BTX-A treatment in children with CP is summarized.Part 1--Intervention studies on BTX-A treatment in children with CP between 4-18 years that used 3DGA data as an outcome measure and were written in English, were identified through a broad systematic literature search. Reported kinematic and kinetic gait features were extracted from the identified studies. Part 2--A retrospective sample of 53 children with CP (6.1 ± 2.3years, GMFCS I-III received 3DGA before and after multilevel BTX-A injections. The effect of BTX-A on gait was interpreted by comparing the results of paired samples t-tests on the kinematic gait features that were identified from literature to the results of statistical parametric mapping analysis on the kinematic waveforms of the lower limb joints.Part 1-53 kinematic and 33 kinetic features were described in literature. Overall, there is no consensus on which features should be evaluated after BTX-A treatment as 49 features were reported only once or twice. Part 2--Post-BTX-A, both statistical approaches found increased ankle dorsiflexion throughout the gait cycle. Statistical parametric mapping analyses additionally found increased knee extension during terminal stance. In turn, feature analyses found increased outtoeing during stance after BTX-A.This study confirms that BTX-A injections are a valuable treatment option to improve gait function in children with CP. However, different statistical approaches may lead to different interpretations of treatment outcome. We suggest that a clear, definite hypothesis should be stated a priori and a commensurate statistical approach should accompany this hypothesis.

  10. Prevention and treatment of early hypertrophic scars with botulinum toxin type A%A型肉毒毒素预防与治疗早期增生性瘢痕的临床初探

    Institute of Scientific and Technical Information of China (English)

    于波; 陈敏亮; 刘文阁; 徐永成; 孙同柱

    2008-01-01

    Objective To explore the effect of botulinum toxin type A(BTXA)in the treatment of early hypertrophic scars(HTS).Methods BTXA was injected into and around the eady HTS,and then the modal and histological changes of the scars as well as the clinical reaction were observed in the patient.BTXA was also injected into muscle around the incision and effect on the cicatrization observed.Results Injection of BTXA could obviously alleviate ache and pruritus of eady HTS and could impel the atrophy and inteneration of eady HTS.Changes were found in paraffin-embedded tissue section by the hemetoxylin and eosin(HE)staining.Injection of BTXA into muscle around the cut could can reduce occurrence of HTS.Conclusion BTXA can help prevent the early HTS to a certain extent.The mechanism underlying this effect may be related to the reducing the tension around scars and proliferative activity,interfering with the signal transduction of small nerves,affecting the proliferation and apoptosis of fibroblasts and subsequently decreasing the collagen synthesis.%目的 探索A型肉毒毒素(botulinum toxin type A,BTXA)对早期增生性瘢痕(hypertrophic scar,HTS)的临床预防及治疗效果.方法 早期HTS周围及组织内注射BTXA,观察瘢痕注射药物后形态学变化、组织学变化及临床症状表现;手术切口缝合后即刻向周围肌肉浅层注射BTXA,观察远期瘢痕愈合情况.结果 局部注射BTXA可以明显减轻早期HTS疼痛和瘙痒症状,促使瘢痕组织萎缩、软化;组织切片HE染色显示HTS组织内结构有所变化.同时,手术切口周围肌肉浅层注射BTXA可以降低术后切口HTS的发生、发展概率.结论 BTXA对早期HTS具有一定程度的治疗和预防作用,其疗效可能是通过降低瘢痕两侧张力及活动,干扰瘢痕内小神经传导,以及影响成纤维细胞增殖分化,促进凋亡进而减少胶原合成而起作用.

  11. Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action

    Directory of Open Access Journals (Sweden)

    Jia-Fong Jhang

    2016-04-01

    Full Text Available The use of onabotulinumtoxinA (BoNT-A for the treatment of lower urinary tract diseases (LUTD has increased markedly in recent years. The indications for BoNT-A treatment of LUTD now include neurogenic or idiopathic detrusor overactivity, interstitial cystitis/bladder pain syndrome and voiding dysfunction. The mechanisms of BoNT-A action on LUTDs affect many different aspects. Traditionally, the effects of BoNT-A were believed to be attributable to inhibition of acetylcholine release from the presynaptic efferent nerves at the neuromuscular junctions in the detrusor or urethral sphincter. BoNT-A injection in the bladder also regulated sensory nerve function by blocking neurotransmitter release and reducing receptor expression in the urothelium. In addition, recent studies revealed an anti-inflammatory effect for BoNT-A. Substance P and nerve growth factor in the urine and bladder tissue decreased after BoNT-A injection. Mast cell activation in the bladder also decreased. BoNT-A-induced improvement of urothelium function plays an important mitigating role in bladder dysfunction. Vascular endothelial growth factor expression in urothelium decreased after BoNT-A injection, as did apoptosis. Studies also revealed increased apoptosis in the prostate after BoNT-A injection. Although BoNT-A injection has been widely used to treat different LUTDs refractory to conventional treatment, currently, onabotulinumtoxinA has been proven effective only on urinary incontinence due to IDO and NDO in several large-scale clinical trials. The effects of onabotulinumtoxinA on other LUTDs such as interstitial cystitis, benign prostatic hyperplasia, dysfunctional voiding or detrusor sphincter dyssynergia have not been well demonstrated.

  12. Prospective randomised controlled trial comparing trigone-sparing versus trigone-including intradetrusor injection of abobotulinumtoxinA for refractory idiopathic detrusor overactivity.

    LENUS (Irish Health Repository)

    Manecksha, Rustom P

    2012-05-01

    Botulinum toxin A is effective for treatment of idiopathic detrusor overactivity (IDO). The trigone is generally spared because of the theoretical risk of vesicoureteric reflux (VUR), although studies assessing injection sites are lacking.

  13. Efficacy and safety of a single botulinum type A toxin complex treatment (Dysport) for the relief of upper back myofascial pain syndrome: results from a randomized double-blind placebo-controlled multicentre study.

    Science.gov (United States)

    Göbel, Hartmut; Heinze, Axel; Reichel, Gerhard; Hefter, Harald; Benecke, Reiner

    2006-11-01

    Botulinum type A toxin (BoNT-A) has antinociceptive and muscle-relaxant properties and may help relieve the symptoms of myofascial pain syndrome. In this study we evaluated the efficacy and tolerability of BoNT-A (Dysport) in patients with myofascial pain syndrome of the upper back. We conducted a prospective, randomized, double-blind, placebo-controlled, 12-week, multicentre study. Patients with moderate-to-severe myofascial pain syndrome affecting cervical and/or shoulder muscles (10 trigger points, disease duration 6-24 months) were randomized to Dysport or saline. Injections were made into the 10 most tender trigger points (40 units per site). The primary outcome was the proportion of patients with mild or no pain at week 5. Secondary outcomes included changes in pain intensity and the number of pain-free days per week. Tolerability and safety were also assessed. At week 5, significantly more patients in the Dysport group reported mild or no pain (51%), compared with the patients in the placebo group (26%; p=0.002). Compared with placebo, Dysport resulted in a significantly greater change from baseline in pain intensity during weeks 5-8 (ppain between weeks 5 and 12 (p=0.036). Treatment was well tolerated, with most side effects resolving within 8 weeks. In conclusion, in patients with upper back myofascial pain syndrome, injections of 400 Ipsen units of Dysport at 10 individualised trigger points significantly improved pain levels 4-6 weeks after treatment. Injections were well tolerated.

  14. 肉毒毒素B在儿童脑性瘫痪中的应用%Application of Botulinum Toxin B in Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    王雅洁

    2012-01-01

    肉毒毒素(BTX)是由肉毒菌素产生的一种细菌外毒素,是已知最毒的微生物毒素之一.BTX-B是由B型厌氧梭状肉毒芽胞杆菌Bean株产生的神经毒素,BTX-B不干扰内化、易位过程,在细胞基质裂解N-乙基-马来酰亚胺-敏感因子-附着蛋白受体复合物中的囊泡相关膜蛋白,干扰突触囊泡锚靠、融合,从而导致肌肉化学性失神经,降低肌肉痉挛.BTX-B还可适用于对BTX-A无反应以及不随意肌肌紧张的患儿.%Botulinum toxin( BTX )is a protein and neurotoxin produced by the bacterium clostridium botulinum, which is one of the most potent toxins known. BTX acts by blocking neurotransmitter release at the neuromuscular junction. BTX-B is produced by fermentation of the bacterium clostridium botulinum type B ( Bean strain). BTX-B does not interfere intemalization, translocation process, but cleaves synaptobrevin, which is a part of a protein complex necessary for proper docking and fusion. BTX-B blocks nerve activity in the muscles, causing a temporary reduction in muscle activity. BTX-B can be used as an effective and powerful medication. Its efficacy extends to patients who are resistant to BTX-A,and it can be used to treat involuntary muscle contractions.

  15. Botulinum toxin in masticatory muscles of the adult rat induces bone loss at the condyle and alveolar regions of the mandible associated with a bone proliferation at a muscle enthesis.

    Science.gov (United States)

    Kün-Darbois, Jean-Daniel; Libouban, Hélène; Chappard, Daniel

    2015-08-01

    In man, botulinum toxin type A (BTX) is injected in masticatory muscles for several indications such as trismus, bruxism, or masseter hypertrophy. Bone changes in the mandible following BTX injections in adult animal have therefore became a subject of interest. The aim of this study was to analyze condylar and alveolar bone changes following BTX unilateral injections in masseter and temporal muscles in adult rats. Mature male rats (n = 15) were randomized into 2 groups: control (CTRL; n = 6) and BTX group (n= 9). Rats of the BTX group received a single injection of BTX into right masseter and temporal muscles. Rats of the CTRL group were similarly injected with saline solution. Rats were sacrificed 4 weeks after injections. Masticatory muscles examination and microcomputed tomography (microCT) were performed. A significant difference of weight was found between the 2 groups at weeks 2, 3 and 4 (p muscles was observed in all BTX rats. MicroCT analysis showed significant bone loss in the right alveolar and condylar areas in BTX rats. Decrease in bone volume reached -20% for right alveolar bone and -35% for right condylar bone. A hypertrophic bone metaplasia at the digastric muscle enthesis was found on every right hemimandible in the BTX group and none in the CTRL group. BTX injection in masticatory muscles leads to a significant and major mandible bone loss. These alterations can represent a risk factor for fractures in human. The occurrence of a hypertrophic bone metaplasia at the Mus Digastricus enthesis may constitute an etiological factor for tori.

  16. Botulinum therapy for poststroke spasticity of the lower extremity (clinical cases

    Directory of Open Access Journals (Sweden)

    L. V. Krylova

    2014-01-01

    Full Text Available The paper deals with the topical problem – the medical rehabilitation of patients with poststroke spasticity. It describes clinical cases of patients with poststroke spasticity of the upper and lower extremities who have received combined therapy using botulinum toxin type A (Botox injections.

  17. O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

    Directory of Open Access Journals (Sweden)

    Hélio A. G. Teive

    2001-03-01

    Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

  18. A型肉毒毒素治疗消化道动力性疾病的新进展%The new progress of botulinum toxin A in the therapy of gastrointestinal motility disorders

    Institute of Scientific and Technical Information of China (English)

    陈英; 刘庆森; 杨云生; 杨春敏; 郭明洲

    2011-01-01

    自上世纪八十年代以来,A型肉毒毒素(BTX-A)已广泛应用于肌肉痉挛性疾病的治疗,主要是神经病学、眼科学、美容医学、疼痛学等领域.近来,越来越多的实验表明,BTX-A 用于消化道平滑肌运动障碍性疾病的治疗是有效的,尤其是治疗贲门失迟缓症和肛裂的研究开展得最为广泛.而将BTX-A应用于病态肥胖领域的新研究,近年来也取得了初步成效.本文描述了BTX-A应用于消化道平滑肌功能失调方面的作用原理、使用方法、适应证、副反应等,同时也比较了BTX-A与其他方法的不同.%Since 1980's, botulinum toxin has been employed for the treatment of various voluntary muscle spastic disorders. Botulinum toxin has been proved to be effective in the therapy of dyskinetic smooth muscle disorders of the gastrointestinal tract. Achalasia and anal fissure are the gastrointestinal disorders in which botulinum toxin therapy has been most extensively investigated. More recently, the new research in the therapy of pathologic pathosis obesity is beginning. This article described the mechanism of action, rationale of employment, indications and side-effects of botulinum toxin application in smooth muscle disorders of the gastrointestinal tract, and compared the results of different techniques of botulinum toxin therapeutic application.

  19. Comparison of clinical efficacy between radiofrequency ablation and botulinum toxin type A in treatment of benign masseter hypertrophy%射频消融与A型肉毒毒素治疗咬肌良性肥大的临床效果比较

    Institute of Scientific and Technical Information of China (English)

    陈刚; 黄金龙; 张骏; 刘育凤; 闻可; 刘宁; 王金明

    2015-01-01

    Objective To evaluate masseter thickness and its complications of radiofrequency ablation and botulinum toxin type A in the treatment of masseter hypertrophy.Methods Totally 36 patients of benign masseter hypertrophy were randomly divided into radiofrequency ablation therapy group (18 patients) and the injection of botulinum toxin type A treatment group (18 patients).The thickness of the masseter and complications were analyzed before treatment,6 months and 12 months after treatment.Results The average thickness of masseter muscle in botulinum toxin type A and radiofrequency ablation groups was significantly reduced 6 or 12 months after treatment,and the difference was statistically significant (P<0.05).However,the thickness of masseter muscle in radiofrequency ablation group after 12 months reduced greater than that in botulinum toxin type A group (P<0.05).Complications of botulinum toxin type A group were swallow difficulty (one patient),unnatural facial expressions (4 patients) and pain at injection site (10 patients) and that in radiofrequency ablation treatment group were that 18 patients had swelling of the skin 1 to 2 weeks after treatment.All patients had recovery 2 weeks after treatment.There was no facial nerve,parotid duct injury,or oral dysfunction.Conclusions The lasting effect of radiofrequency ablation treatment for benign masseter hypertrophy is longer than that of botulinum toxin type A.%目的 比较射频消融和A型肉毒毒素注射治疗咬肌肥大的临床效果.方法 将36例咬肌良性肥大的患者按照治疗方法不同完全随机分为接受射频消融治疗组和注射A型肉毒毒素治疗组,每组18例.评价治疗前、治疗后6个月、12个月时咬肌的厚度及并发症.结果 A型肉毒杆菌毒素治疗组中,与治疗前相比,右侧或左侧平均咬肌厚度治疗后6、12个月明显减少,差异有统计学意义(P<0.05).射频消融治疗组中,与治疗前相比,治疗后6、12个月咬

  20. Utilización de la toxina botulínica para mejorar la funcionalidad y la expresión del labio en parálisis facial de larga evolución Use of botulinum toxin to improve the functionality and expression of the lip in long-term facial palsy

    Directory of Open Access Journals (Sweden)

    C. Gómez Martín

    2010-06-01

    Full Text Available La parálisis de la rama marginal del nervio facial en el contexto de una parálisis facial de larga evolución, produce una deformidad estética y funcional que puede ser mejorada con la inyección de toxina botulínica. Utilizamos esta técnica en 2 pacientes consiguiendo unos resultados casi inmediatos en lo que se refiere a la apertura bucal, a la expresión y a la continencia oral. Indicamos esta técnica en pacientes de edad avanzada, con múltiples operaciones previas y que aceptan este procedimiento no invasivo para mejorar su autoestima y su calidad de vida.Paralysis of the marginal branch of the facial nerve in the context of a long-term facial paralysis, produces an aesthetic and functional deformity that can be improved with botulinum toxin injection. We use this technique in 2 patients who achieved almost immediate results in terms of oral opening, oral expression and continence. Botulinum toxin injection can be used in elderly patients with multiple previous operations who accept this non-invasive procedure, improving their selfesteem and their quality of life.

  1. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Sirpa Mustalampi

    2016-01-01

    Full Text Available Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD during a 12-week period following botulinum neurotoxin (BoNT injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability.

  2. Reduced Neck Muscle Strength and Altered Muscle Mechanical Properties in Cervical Dystonia Following Botulinum Neurotoxin Injections: A Prospective Study

    Science.gov (United States)

    Mustalampi, Sirpa; Ylinen, Jari; Korniloff, Katariina; Weir, Adam; Häkkinen, Arja

    2016-01-01

    Objective To evaluate changes in the strength and mechanical properties of neck muscles and disability in patients with cervical dystonia (CD) during a 12-week period following botulinum neurotoxin (BoNT) injections. Methods Eight patients with CD volunteered for this prospective clinical cohort study. Patients had received BoNT injections regularly in neck muscles at three-month intervals for several years. Maximal isometric neck strength was measured by a dynamometer, and the mechanical properties of the splenius capitis were evaluated using two myotonometers. Clinical assessment was performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) before and at 2, 4, 8, and 12 weeks after the BoNT injections. Results Mean maximal isometric neck strength at two weeks after the BoNT injections decreased by 28% in extension, 25% in rotation of the affected side and 17% in flexion. At four weeks, muscle stiffness of the affected side decreased by 17% and tension decreased by 6%. At eight weeks, the muscle elasticity on the affected side increased by 12%. At two weeks after the BoNT injections, the TWSTRS-severity and TWSTRS-total scores decreased by 4.3 and 6.4, respectively. The strength, muscle mechanical properties and TWSTRS scores returned to baseline values at 12 weeks. Conclusions Although maximal neck strength and muscle tone decreased after BoNT injections, the disability improved. The changes observed after BoNT injections were temporary and returned to pre-injection levels within twelve weeks. Despite having a possible negative effect on function and decreasing neck strength, the BoNT injections improved the patients reported disability. PMID:26828215

  3. Presence of Cleaved Synaptosomal-Associated Protein-25 and Decrease of Purinergic Receptors P2X3 in the Bladder Urothelium Influence Efficacy of Botulinum Toxin Treatment for Overactive Bladder Syndrome.

    Directory of Open Access Journals (Sweden)

    Hsin-Tzu Liu

    Full Text Available To evaluate whether botulinum toxin A (BoNT-A injection and Lipotoxin (liposomes with 200 U of BoNT-A instillation target different proteins, including P2X3, synaptic vesicle glycoprotein 2A, and SNAP-25, in the bladder mucosa, leading to different treatment outcomes.This was a retrospective study performed in a tertiary teaching hospital. We evaluated the clinical results of 27 OAB patients treated with intravesical BoNT-A injection (n = 16 or Lipotoxin instillation (n = 11. Seven controls were treated with saline. Patients were injected with 100 U of BoNT-A or Lipotoxinin a single intravesical instillation. The patients enrolled in this study all had bladder biopsies performed at baseline and one month after BoNT-A therapy. Treatment outcome was measured by the decreases in urgency and frequency episodes at 1 month. The functional protein expressions in the urothelium were measured at baseline and after 1 month. The Wilcoxon signed-rank test and ordinal logistic regression were used to compare the treatment outcomes.Both BoNT-A injection and Lipotoxin instillation treatments effectively decreased the frequency of urgency episodes in OAB patients. Lipotoxin instillation did not increase post-void residual volume. BoNT-A injection effectively cleaved SNAP-25 (p < 0.01. Liposome encapsulated BoNT-A decreased urothelial P2X3 expression in the five responders (p = 0.04, while SNAP-25 was not significantly cleaved.The results of this study provide a possible mechanism for the therapeutic effects of BoNT-A for the treatment of OAB via different treatment forms. BoNT-A and Lipotoxin treatments effectively decreased the frequency of urgency episodes in patients with OAB.

  4. Effect of Botulinum Neurotoxin A Injection into the Submucoperichondrium of the Nasal Septum in Reducing Idiopathic Non-Allergic Rhinitis and Persistent Allergic Rhinitis

    OpenAIRE

    Mozafarinia, Keramat; Abna, Mehdi; Narges KHANJANI

    2015-01-01

    Introduction: Submucoperichondrial injection of botulinum neurotoxin A (BTA) in the nasal septum is a promising therapeutic option in the treatment of persistent allergic rhinitis (AR) and non-allergic rhinitis, and is safer and more effective than intraturbinate injection in reducing clinical symptoms. Materials and Methods: Forty patients diagnosed with persistent AR or non-allergic rhinitis referred to Shafa Medical Center affiliated to Kerman University of Medical Sciences were included i...

  5. Application of botulinum toxin in rehabilitation:a review%肉毒毒素在康复医学中的应用

    Institute of Scientific and Technical Information of China (English)

    袁志红; 张长杰

    2005-01-01

    肉毒毒素(botulinum toxins, BTXs)是从肉毒杆菌属中获得的嗜神经毒素.依其毒性和抗原性的不同,分为A~G 7型.其中毒力最强的是A型肉毒杆菌毒素(BTXA),它是最早被提纯为结晶,生产工艺最成熟,最早应用于实验研究,也是目前临床最常用的.现就其作用机制、在康复医学中的应用和应用要点综述如下.

  6. A STUDY OF VOICE CHANGES IN SPASMODIC DYSPHONIA AFTER BOTULINUM THERAPY

    Directory of Open Access Journals (Sweden)

    Sanajeet Kumar

    2016-03-01

    Full Text Available BACKGROUND Spasmodic dysphonia is a neurological disorder, which can give the voice a strained quality. There is currently no cure for spasmodic dysphonia. The most common treatment for spasmodic dysphonia is the injection of botulinum toxin. METHODS Botulinum toxin A injection was performed in 10 patients with adductor spasmodic dysphonia. Voice handicap index scoring and voice analysis was done pre- and post-injection. Fundamental frequency, standard deviation of fundamental frequency, jitter, shimmer, mean phonation time and voice noise energy was studied in voice analysis. These voice parameters were measured from sustained phonation of vowel /a/. RESULTS Results of study indicated, a Spasmodic dysphonia patients had high mean values for voice handicap index score and all voice parameters. b All parameters were reduced significantly post botulinum therapy, but remained higher than their normal value. c All voice parameters except jitter showed strong positive correlation with voice handicap index in all domains. Jitter showed moderate positive correlation with total score, physical and emotional domain and strong positive correlation with functional domain. CONCLUSION Botulinum toxin A injection improves voice in cases of spasmodic dysphonia, significantly still post procedure voice does not return to normal.

  7. A型肉毒素治疗痉挛型脑性瘫痪120例临床疗效分析%Clinical Efficacy Analysis of Botulinum Toxin Type A Treating 120 Cases of Spastic Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    李华伟; 马丙祥

    2013-01-01

    Objective:To investigate the curative effects of injection with botulinum toxin type A (BTX-A) and rehabilitation therapy on spastic cere-bral palsy (CP), with location-guide of electrical stimulation. Methods:120 cases of children with spastic cerebral palsy received BTX-A injection and comprehensive rehabilitation treatment afterwards with electrical stimulation guided, to observe the changes of muscle tension and range of joint passive motion. Results:Muscle tension decreased significantly after the injection (P<0.01);range of joint passive motion significantly increased (P<0.05). Conclusion:BTX-A injection can significantly reduce muscle tension, enlarge range of joint motion and improve motor function in children with cerebral palsy.%  目的:探讨电刺激定位引导下A型肉毒毒素(BTX-A)注射结合康复治疗对痉挛性脑性瘫痪(CP)的治疗效果。方法:120例痉挛性脑瘫患儿均在电刺激仪引导下,进行BTX-A注射,注射后接受综合康复治疗,并观察其肌张力和关节被动活动度的变化。结果:注射后患儿的肌张力均明显降低(P<0.01);关节被动活动度均明显增大(P<0.05)。结论:BTX-A注射能显著降低脑瘫患儿的肌张力,扩大关节活动度,提高运动功能。

  8. A 型肉毒毒素 ELISA 鉴别试验方法的建立%Establishment of an ELISA identification for botulinum toxin type A

    Institute of Scientific and Technical Information of China (English)

    萧在澜; 王媛; 顾磊; 杨雨生; 赵建荣; 徐永浩; 张华捷

    2015-01-01

    Objective To establish a new identification method for botulinum toxin type A ( botA) to replace the traditional animal test.Methods A double antibody sandwich ELISA was established based on the modern immunological technolo-gy, by using prepared two kinds of anti-botA polyclonal antibodies derived from equine and rabbit origin, and a preliminary verification test was performed.Results The established identification ELISA could be a potential alternative method in re-placement of animal test, it is of good specificity, sensitivity, precision and robustness.Conclusion The established method will be expected to be approved for the identification test of botulinum toxin type A as the replacement method for traditional animal test by a further verification and validation.%目的:建立鉴定A型肉毒毒素的ELISA鉴别试验方法以替代传统的动物试验法。方法采用现代免疫学技术,制备马源性和兔源性抗A型肉毒毒素多克隆抗体,建立了双抗体夹心ELISA,并就此初步进行方法学验证。结果所建立的ELISA具有良好的特异性、灵敏度、精密度和耐用性,具有替代动物试验方法的良好前景。结论在进一步验证和确认之后,该方法有望正式成为可用于鉴定A型肉毒毒素的试验方法以替代动物试验法。

  9. Botulinum toxin: mechanisms of action Toxina botulínica: mecanismos de ação

    Directory of Open Access Journals (Sweden)

    Dirk Dressler

    2005-03-01

    Full Text Available This review describes therapeutically relevant mechanisms of action of botulinum toxin (BT. BT's molecular mode of action includes extracellular binding to glycoproteine structures on cholinergic nerve terminals and intracellular blockade of the acetylcholine secretion. BT affects the spinal stretch reflex by blockade of intrafusal muscle fibres with consecutive reduction of Ia/II afferent signals and muscle tone without affecting muscle strength (reflex inhibition. This mechanism allows for antidystonic effects not only caused by target muscle paresis. BT also blocks efferent autonomic fibres to smooth muscles and to exocrine glands. Direct central nervous system effects are not observed, since BT does not cross the blood-brain-barrier and since it is inactivated during its retrograde axonal transport. Indirect central nervous system effects include reflex inhibition, normalisation of reciprocal inhibition, intracortical inhibition and somatosensory evoked potentials. Reduction of formalin-induced pain suggests direct analgesic BT effects possibly mediated through blockade of substance P, glutamate and calcitonin gene related peptide.O propósito deste artigo é uma revisão dos mecanismos de ação da toxina botulínica (TB relevantes para a compreensão do seu uso terapêutico. A ação da TB a nível molecular consiste na sua ligação extracelular a estruturas glicoprotéicas em terminais nervosos colinérgicos e no bloqueio intracelular da secreção de acetilcolina. A TB interfere no reflexo espinal de estiramento através do bloqueio de fibras musculares intrafusais causando redução da sinalização aferente veiculada por fibras Ia e II e do tono muscular. Portanto, o efeito da TB pode estar relacionado não somente à paresia muscular mas também à inibição reflexa espinal. A TB promove ainda o bloqueio de fibras autonômicas para músculos lisos e glândulas exócrinas. Apesar de ocorrer alguma difusão sistêmica após a aplica

  10. Progress on botulinum toxin for tumors’therapy and adjuvant therapy%肉毒毒素在肿瘤治疗和辅助治疗领域的研究进展

    Institute of Scientific and Technical Information of China (English)

    苏娟(综述); 张雪平(审校)

    2015-01-01

    Botulinum toxin is a bacterial exotoxin generated in the growth of the clostridium botulinum.Nervous’physiolog-ical functions can be inhibited by botulinum toxin to block release of related neurotransmitters.The toxin has a variety of clinical indications,such as neurology,orthopaedics,rehabilitation,urology.Recent study has found that the botulinum toxin as a antagonist for muscarine receptor can prevent the vagus nerve from releasing the acetylcholine,so as to surpress the occurrence and development of gastric cancer.In addition,botulinum toxin can cause neurological vasodilatation by blocking release of neurotransmitters,for example norepinephrine,leading to open the nerve tumor vascular network to im-prove the curative effect of the tumors’radiotherapy and chemotherapy.This paper reviewed the present development in re-search of botulinum toxin for tumors’therapy and adjuvant therapy.%肉毒毒素是肉毒梭状芽胞杆菌生长繁殖过程中产生的一种细菌外毒素。它可以通过抑制相关神经递质的释放而抑制神经的生理作用,目前临床适应症涉及神经内科、整形外科、康复科、泌尿科等多领域。最新研究发现,肉毒毒素作为毒蕈碱受体拮抗剂可抑制迷走神经释放乙酰胆碱,从而抑制胃癌的发生与发展。同时发现肉毒毒素可通过阻断去甲肾上腺素等神经递质的释放引起神经性的血管舒张,从而打开肿瘤神经血管网来改善肿瘤的放射和化学治疗的疗效。现就其在肿瘤治疗及其辅助治疗相关领域的研究现状进行了综述。

  11. Detection of botulinum neurotoxin serotype B at sub mouse LD(50 levels by a sandwich immunoassay and its application to toxin detection in milk.

    Directory of Open Access Journals (Sweden)

    Miles C Scotcher

    Full Text Available BACKGROUND: Botulinum neurotoxin (BoNT, the causative agent of botulism, a serious neuroparylatic disease, is produced by the anaerobic bacterium Clostridium botulinum and consists of a family of seven serotypes (A-H. We previously reported production of high-affinity monoclonal antibodies to BoNT serotype A. METHODS AND FINDINGS: Recombinant peptide fragments of the light chain, the transmembrane and receptor-binding domains of the heavy chain of botulinum neurotoxin type B (BoNT/B were expressed in Escherichia coli as GST-fusion proteins and purified. These proteins were used to immunize BALB/cJ mice for the generation of monoclonal antibodies (mAbs. Antibody-producing hybridomas were detected using either a direct binding ELISA binding to plate-immobilized BoNT/B, or with a capture-capture ELISA whereby the capacity of the antibody to capture BoNT/B from solution was tested. A total of five mAbs were selected, two of which bound the toxin light chain and three bound the receptor-binding domain of BoNT/B heavy chain. MAb MCS6-27 was identified via capture-capture ELISA and was the only mAb able to bind BoNT/B in solution under physiological conditions. MAbs F24-1, F26-16, F27-33 and F29-40 were identified via direct binding ELISA, and were able to capture BoNT/B in solution only in the presence of 0.5-0.9 mM sodium dodecyl sulphate (SDS. MAb MCS6-27 and an anti-BoNT/B polyclonal antibody were incorporated into a sandwich ELISA that did not require SDS. CONCLUSIONS: We report here the generation of monoclonal antibodies to serotype B and the subsequent development of a sensitive sandwich immunoassay. This immunoassay has a detection limit of 100 fg BoNT/B, fifty times more sensitive than the mouse bioassay detection limit of 5 pg BoNT/B. Additionally, this assay detected as little as 39 pg/mL of toxin in skim, 2% and whole milk.

  12. [Techniques to enhance the accuracy and efficiency of injections of the face in aesthetic medicine].

    Science.gov (United States)

    Manfrédi, P-R; Hersant, B; Bosc, R; Noel, W; Meningaud, J-P

    2016-02-01

    The common principle of injections in esthetic medicine is to treat and to prevent the signs of aging with minimal doses and with more precision and efficiency. This relies on functional, histological, ultrasound or electromyographic analysis of the soft tissues and of the mechanisms of facial skin aging (fine lines, wrinkles, hollows). These injections may be done with hyaluronic acid (HA) and botulinum toxin. The aim of this technical note was to present four delivery techniques allowing for more precision and low doses of product. The techniques of "vacuum", "interpores" and "blanching" will be addressed for HA injection and the concept of "Face Recurve" for botulinum toxin injection. PMID:26740201

  13. Botulinum neurotoxin type A versus punctal plug insertion in the management of dry eye disease

    Directory of Open Access Journals (Sweden)

    Amal A Bukhari

    2014-01-01

    Full Text Available Purpose: To compare the efficacies of punctal plug insertion and Botulinum toxin injection in dry eye disease not responding to topical medications. Materials and Methods: A non-controlled randomized clinical trial of two parallel groups of 60 dry eye patients seen in the clinic not responding to topical medications were divided into two groups. One group received punctal plugs and the other group received Botulinum toxin injections to prevent lacrimal tear drainage. Results: Of a total of 36 patients with a mean age of 44.5 years who received punctal plugs, 50% of them experienced improvements in the clinical manifestations of their disease. 12/36 (33.3% developed plug extrusion, and 6/36 (16.7% patients developed conjunctival erosions with irritation that necessitated plug removal within one week of insertion. A total of 24 patients with a mean age of 47.5 years received injections of Botulinum toxin. Of these, 83.3% had improvement in all of the clinical manifestations of dry eye. 4/24 (16.7% had no improvement in the degrees to which they experienced foreign body sensations, 33.3% reported shampoo entering the eye while showering. All of the patients who received Botulinum toxin injections were satisfied with the results of their treatment, whereas only 72.3% of the patients who received punctal plugs were satisfied with their results. Conclusion: Botulinum neurotoxin A injections can be a very good alternative to punctal plugs in improving the clinical manifestations of dry eye disease They are associated with the development of fewer and milder complications and with higher levels of patient satisfaction.

  14. The pharmacodynamics experiment of XinHua injection protect action of ADR-induced toxin myocarditisin mice

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong; DU Jia-lin; LI Xin-hua; XIANG Shao-jie; JIA Dong; BAO Yu-long; LI Kun

    2008-01-01

    Objective The experiment is to study the protective effects of Xinkang Injection on ADR-induced toxin myocarditisin mice. Methods The test of Xinkang Injection on ADR-induced toxin myocarditisin mice. Firstly, the animal of obnormal, weight and death rate. Secondly, the influnences of cardiogram of ADR-induced toxin myocarditisin mice. Thirdly, the influnences of lactate dehydrogenase (LDH), creatine kinase (CK) and glutamic oxaloacetic transaminasw (GOT) of ADR-induced toxin myocarditisin mice. Fouthly, the influnences of changes of cardioc pathological mechanism of ADR-induced toxin myocarditisin mice. Fifthly, the influnces of the caidioc ultrastructural of ADR-induced toxin myocarditisin mice. Results Firstly, to ADR-induced toxin myocarditisin mice, the weight of middle dose and high dose of Xinkang injection had declined obviosly which contrast with the constraction model mice team. In the mean time, the weight of Xinkang injection team had obviosly changde which contrast with contrastion mice team(P<0.01 ). Secondly, to ADR-induced toxin myocarditisin mice, the middle dose and high dose of Xinkang injection have obviosly withstand Q abnormal cardiogram, in the meantime, Xinkang injection team had obviosly changde contrast with the contrastion model mice (P<0.01 ). Thirdly, to ADR-induced toxin myocarditisin mice, The activity of lactate dehydrogenase(LDH),creatine kinase (CK) and glutamic oxaloacetic transaminasw (GOT) were differently measured. The middle dose and high dose of Xinkang injection team can obviously declined the activity of LDH and CK (P<0.01). Fouthly, to ADR-induced toxin myocarditisin mice, the low dose, the middle dose and high dose of Xinkang injection team can contrast w, ith injured on toxic myocarditisin mice cardioc. Fifthly, to ADR-induced toxin myocarditisin mice, the low dose , the middle dose and high dose of Xinkang injection team have effect of allevite the injection of the cardioc ulteasteuctural of ADR-induced toxin

  15. Tetanus: Pathophysiology, Treatment, and the Possibility of Using Botulinum Toxin against Tetanus-Induced Rigidity and Spasms

    OpenAIRE

    Bjørnar Hassel

    2013-01-01

    Tetanus toxin, the product of Clostridium tetani, is the cause of tetanus symptoms. Tetanus toxin is taken up into terminals of lower motor neurons and transported axonally to the spinal cord and/or brainstem. Here the toxin moves trans-synaptically into inhibitory nerve terminals, where vesicular release of inhibitory neurotransmitters becomes blocked, leading to disinhibition of lower motor neurons. Muscle rigidity and spasms ensue, often manifesting as trismus/lockjaw, dysphagia, opistoton...

  16. Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

    OpenAIRE

    Cannito, Michael

    2008-01-01

    Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botu...

  17. Presence of fusion in albinism after strabismus surgery augmented with botulinum toxin (type a) injection.

    Science.gov (United States)

    Tavakolizadeh, Sepideh; Farahi, Azadeh

    2013-08-01

    It is commonly accepted that albino patients with strabismus rarely achieve binocularity and depth perception after strabismus surgery. The presence of retino-geniculo-cortical misrouting, a hallmark of the visual system in albinism, does not necessarily cause total loss of binocular vision, however, not even in albino patients with strabismus. Recently some degrees of stereopsis were reported in albinism patients with minimal clinical nystagmus, if any, in the absence of strabismus. It is possible that patients with albinism and strabismus have binocular visual potential which appears after strabismus correction and provides appropriate postoperative alignment in the long term. Here we present two cases of clinically diagnosed oculocutaneous albinism, an 18-year-old girl and a 16-year-old boy, both with exotropia ≥40 prism diopter, who gained acceptable alignment and fusion after surgical correction of their strabismus as demonstrated on Bagolini testing. In cases of albinism accompanied by visual pathway abnormalities and strabismus, binocular visual potential is not impossible, and some levels can be expected. Thus, these patients, like other cases of strabismus, may benefit from treatment of strabismus at an earlier age to achieve appropriate alignment, cosmetic satisfaction, and a possibly increased chance of fusion.

  18. Treatment of cervical dystonia with botulinum toxin in a patient with myasthenia gravis Tratamento de distonia cervical com toxina botulínica em uma paciente com miastenia gravis

    Directory of Open Access Journals (Sweden)

    MARCIA RUBIA R. GONÇALVES

    1999-09-01

    Full Text Available We report the case of a 49-year-old woman who has the rare combination of myasthenia gravis and cervical dystonia. She was treated with botulinum toxin type A with good response and no evidence of deterioration of the myasthenic symptoms. We therefore conclude that it is possible to use botulinum toxin in the presence of defective neuromuscular transmission.Relatamos o caso de uma mulher de 49 anos com rara combinação de miastenia gravis e distonia cervical tratada com toxina botulínica tipo A, apresentando boa resposta e nenhuma evidência de piora do quadro miastênico. A partir dessas observações concluimos que é possível o uso de toxina botulínica na presença de doença da transmissão neuromuscular.

  19. Neutralizing antibodies to botulinum neurotoxin type A in aesthetic medicine: five case reports

    Directory of Open Access Journals (Sweden)

    Torres S

    2013-12-01

    Full Text Available Sebastian Torres,1 Mark Hamilton,2 Elena Sanches,4 Polina Starovatova,3 Elena Gubanova,3 Tatiana Reshetnikova51Di Stefano Velona Clinic, Catania, Italy; 2Hamilton Face Clinic, Dublin, Ireland; 3Preventive Medicine Clinic "Vallex M", Moscow, Russia; 4EKLAN Co Ltd Medical Center for Aesthetic Correction, Moscow, Russia; 5Department of Dermatovenereology and Cosmetology, State Medical University, Novosibirsk, RussiaAbstract: Botulinum neurotoxin injections are a valuable treatment modality for many therapeutic indications as well as in the aesthetic field for facial rejuvenation. As successful treatment requires repeated injections over a long period of time, secondary resistance to botulinum toxin preparations after repeated injections is an ongoing concern. We report five case studies in which neutralizing antibodies to botulinum toxin type A developed after injection for aesthetic use and resulted in secondary treatment failure. These results add to the growing number of reports in the literature for secondary treatment failure associated with high titers of neutralizing antibodies in the aesthetic field. Clinicians should be aware of this risk and implement injection protocols that minimize resistance development.Keywords: aesthetic medicine, botulinum neurotoxin type A, neutralizing antibody, secondary treatment failure

  20. Effect of Botulinum Toxin Type A and Jin Three-needle on Treatment of Tip Toes of Children Patient with Spastic Diplegia Cerebral Palsy%A型肉毒毒素与靳三针治疗痉挛型双瘫脑瘫患儿尖足步态的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李金玲; 徐开寿; 李翠玲; 潭红香; 靳晓坤; 郑玉蔼; 麦坚凝

    2012-01-01

    目的 观察A型肉毒毒素注射结合靳三针疗法纠正痉挛型双瘫脑瘫患儿尖足步态的疗效.方法 78例以尖足步态为主的痉挛型双瘫脑瘫患儿,均采用A型肉毒毒素局部注射治疗后,随机分为治疗组40例和对照组38例,两组患儿均采用综合康复治疗的方法,治疗组在此基础上增加靳三针疗法.在治疗前、治疗2周、3个月和6个月时对肌张力、运动功能进行评定.结果 治疗后,两组患儿的观测指标均有改善,治疗组优于对照组(P<0.05).结论 A型肉毒毒素注射结合靳三针疗法治疗痉挛型双瘫脑瘫患儿疗效显著,靳三针疗法可以提高康复治疗的效果.%Objective To observe treatment effect of Jin three-needle combined with injection of Botulinum toxin type A for children with spastic diplegia cerebral palsy. Methods 78 children patients with spastic diplegia were received local injection of botulinum toxin A, and randomly divided into treatment group (40 cases) and control group (38 cases). The two groups were carried out comprehensive rehabilitation therapy. The treatment group was received traditional medicine Jin three-needle therapy. The muscle tension and motor function of patients were evaluated before and after 2 weeks, 3 months, and 6 months treatment. Results The muscle tension, motor function and other index in two groups after treatment were improved, the treatment group were much better than that of control group (P < 0.05 ). Conclusion The combined injection of Botulinum toxin type A with Jin three-needle have significant effect on treatment of children patients with spastic diplegia cerebral palsy; and Jin three-needle could improve the curative effect of rehabilitation.

  1. Toxins

    Science.gov (United States)

    Toxins are substances created by plants and animals that are poisonous to humans. Toxins also include some medicines that are helpful in small doses, but poisonous in large amounts. Most toxins that cause problems ...

  2. Distribution of Tritiated Tetanus Toxin Following an Intraperitoneal Injection in Immunized and Non-Immunized Mice

    International Nuclear Information System (INIS)

    Tetanus toxin, purified by ultra-filtration and precipitation with ammonium sulphate, was lyophilized and exposed to 5 c of tritium gas (Wilzbach procedure) for 2½ d in a deep freeze cabinet at 0.38 atm of pressure. The toxin was then homogenized and the precipitated material removed by filtration through a HA millipore membrane. The filtrate was washed and concentrated in a membrane colloidal dialyzer. The resuspended material (particles estimated to be below 450 mpm in size) was highly toxic when injected into mice. Both the crude precipitate and the suspended toxin were injected into immunized mice and the animals autopsied at various times to determine the presence of radioactivity in the various inflammatory cells. These results were compared with those obtained when the toxins were neutralized and injected into non-immunized mice. In the inflammatory area produced by the injection of tritiated toxin, neutrophils containing radioactivity were found during the first 2 d, and macrophages containing radioactivity were found in the spleen as well as in the inflammatory area for as long as 15 d. Trace amounts of radioactivity were found in eosinophils. No radioactivity was found within mast cells in either the immunized or non-immunized animals. The significance of these results will be discussed in relation to initiation of antitoxin production. (author)

  3. Intrastriatal injection of botulinum neurotoxin-A is not cytotoxic in rat brain - A histological and stereological analysis.

    Science.gov (United States)

    Mehlan, Juliane; Brosig, Hans; Schmitt, Oliver; Mix, Eilhard; Wree, Andreas; Hawlitschka, Alexander

    2016-01-01

    Parkinson's disease (PD) is caused by progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta, resulting in a deficiency of dopamine in the striatum and an increased release of acetylcholine by tonically active interneurons. Botulinum neurotoxin-A (BoNT-A) is well known for blocking transmitter release by cholinergic presynaptic terminals. Treating striatal hypercholinism by local application of BoNT-A could be a possible new local therapy option of PD. In previous studies of our group, we analyzed the effect of BoNT-A injection into the CPu of 6-OHDA lesioned hemiparkinsonian rats. Our studies showed that BoNT-A application in hemiparkinson rat model is capable of abolishing apomorphine induced rotations for approximately 3 months. Regularly occurring axonal swellings in the BoNT-A infiltrated striata were also discovered, which we named BoNT-A induced varicosities (BiVs). Résumé: Here we investigated the long-term effect of the injection of 1ng BoNT-A into the right CPu of naive Wistar rats on the number of ChAT-ir interneurons as well as on the numeric density and the volumetric size of the BiVs in the CPu. Significant differences in the number of ChAT-ir neurons between the right BoNT-A treated CPu and the left untreated CPu were not detected up to 12 month post BoNT-A injection. The numeric density of BiVs in the treated CPu reached a maximum 3 months after BoNT-A treatment and decreased afterwards, whereas the volume of single BiVs increased steadily throughout the whole time course of the experiment. PMID:26562665

  4. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Graham Laura

    2008-10-01

    Full Text Available Abstract Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group or upper limb therapy alone (control group. Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT. Secondary outcomes include: spasticity (Modified Ashworth Scale; grip strength; dexterity (Nine Hole Peg Test; disability (Barthel Activities of Daily Living Index; quality of life (Stroke Impact Scale, Euroqol EQ-5D and attainment of patient-selected goals (Canadian Occupational Performance Measure. Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment

  5. 不同剂量肉毒素A注射治疗神经源性逼尿肌过度反射患者的有效性%Efficacy of different dose of Botulinum toxin A in treatment of patients with neurogenic detrusor overactivity

    Institute of Scientific and Technical Information of China (English)

    唐偲; 沈宏

    2016-01-01

    目的:研究不同浓度肉毒素 A 注射治疗脊髓损伤或者多发性硬化症所导致的神经源性逼尿肌过度反射的作用。方法统计我院2011年6月至2014年12月收治的43例由脊髓损伤或者多发性硬化症所导致的神经源性逼尿肌过度反射患者,完成12周的随访时患者总数为38例,其中20例患者给予200 U 剂量的肉毒素 A(200 U 组),18例患者给予100 U 剂量的肉毒素 A (100 U 组)。38例患者的平均年龄为45.3岁,女性比例高于男性。随访并记录6周及12周后尿失禁患者生活质量(I-QOL)评分相对于基线评分的变化。结果随访结束后,总体 I-QOL 得分的比较显示,200 U 组患者明显高于100 U 组,差异具有统计学意义(P <0.05)。结论肉毒素 A 注射治疗神经源性逼尿肌过度反射有一定的效果,而且200 U 的剂量效果强于100 U。%Objective To research the efficacy of different dose botulinum toxin A in the treatment of patients with neurogenic detrusor overactivity due to spinal cord injury or multiple sclerosis.Methods The datas of 43 patients with neurogenic detrusor overactivity caused by spinal cord injury or multiple sclerosis which accepted treatment in our hostipal were analyzed.And 38 patients were followed up for 12 weeks,of which 20 cases were treated with 200 U botulinum toxin A,and 18 cases received 100 U botulinum toxin A.The average age of 38 patients was 45.3 years old,and the ratio of famale was higher.The incontinence quality of life(I-QOL)changed from baselin after 6 weeks and 12 weeks was recorded.Resluts The final outcomes showed that the efficacy of botulinum toxin A with 200U was better than that with 100 U according to I-QOL score,and the difference was statistical significance(P <0.05).Conclusion The botulinum toxin A has positive effect on neurogenic detrusor overactivity,and the efficacy of 200 U injection is better than that of 100 U.

  6. 肌电图评估在A型肉毒毒素治疗咬肌肥大中的应用%Electromyogram evaluation in botulinum toxin A for treatment of masseteric muscle hypertrophy

    Institute of Scientific and Technical Information of China (English)

    潘盛盛; 李华

    2016-01-01

    复注射维持效果。%Objective To study the safety and efficacy of botulinum toxin A in the treatment of masseteric muscle hypertrophy. Methods Twenty-two patients(42 sides)were treated by intramuscular injection of botulinum toxin A:30-50U for each side of 20 patients with bilateral masseteric hypertrophy;60U for 1 male patient with unilateral hypertrophy;30U for 1 female patient with unilateral hypertrophy.We use the electromyographic measurement to observe the changes in masseter contraction,the effect and complications were recorded at different time.Results The masseteric contraction(evaluated by EMG RMS)at different time post injection was reduced significantly(P<0.001).Maximum reduction was recorded at 4 weeks after injection.The follow-up period was 6-20 months.3 patients(13.6%) were not satisfied with the result:2 patients found no change in masseter thickness;one found the left masseter comes out to be larger than the right in sixth month.5 patients(22.7%) were very satisfied with the effect,14 patients(63.6%) were satisfied with the effect.2 patients(9.1%) begin to see the effect 15 days after the injection;17 patients(77.3%) found it 1 month after the injection and 1 patient(4.5%) found it 2 months after the injection. 7 patients(31.8%) got the obvious effect 1 month after the injection;6 patients(27.3%) got the obvious effect 2 months after the injection;another 6 patients(27.3%)got it 3 months after the injection;1 patient(4.5%) got it 5 months after the injection.2 patients(9.1%) begin to lose effectiveness 5 months after the injection;and 1 patient(4.5%) in sixth month ,6patients(27.3.0%) in seventh month,5 patients(22.7%) in eighth month,6 patients(27.3%) in ninth month;other 2 patients(9.1%) still keep the effect well after 6 months. No long-term severe complications appeared.Mild complications include:3 patient with local swelling and mild pain;3 patients with dysmasesia and one with nausea, which all disappear in a month.Conclusion Botulinum toxin type A injection is a safe and

  7. Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

    Institute of Scientific and Technical Information of China (English)

    Fei Guo; Wei Yue; Li Ren; Yumiao Zhang; Jing Yang

    2006-01-01

    BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE : To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN: A randomized controlled observation.SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University.PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30).METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site.② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were

  8. Long-term curative effect of botulinum toxin A(BTXA) on treating spam of eyelid and facial muscle%肉毒杆菌毒素A治疗眼睑及面肌 痉挛远期疗效观察

    Institute of Scientific and Technical Information of China (English)

    田秋霞; 刘元真

    2000-01-01

    Objective To discuss the long-term curative effect of botulinum toxin A(BTXA) for treating spasm of eyelid and facial muscle.Methods Ninty-two patients with spasm of eyelid and facial muscle were treated with BTXA and observed for a long term.Results After being injected with BTXA for 1~4 days, the spasm relieved gradually. Sixteen weeks later, the spasm symptoms relapsed. The relapse began mostly from eyelid spasm. The facial spasm's relief time was longer. lt might be up to 24 weeks. After injection, the patients had some slight complications of facial expression numb, ptosis and fissura palpebrae. The above complication symptoms recovered by themselves after two weeks. Conclusion The curative effect of BTXA on treating spasm of eyelid and facial muscle is reliable.%目的探讨肉毒杆菌毒素A(botulinum A toxin,BTXA)治疗眼睑及面部肌肉痉挛的远期疗效。方法对92例眼睑及面部肌肉痉挛患者用BTXA注射治疗,随诊观察其远期疗效。结果 BTXA注射后1~4d痉挛逐渐缓解,维持16wk左右后症状复发。复发多由眼睑痉挛开始,面部痉挛缓解时间长,可达24wk。注射后可见表情麻木、上睑下垂、睑裂闭合不全等并发症,但均较轻,且2wk后多能自行恢复。结论 BTXA治疗眼睑面部肌肉痉挛疗效确切。

  9. A cell-permeable fusion protein based on Clostridium botulinum C2 toxin for delivery of p53 tumorsuppressor into cancer cells.

    Directory of Open Access Journals (Sweden)

    Jörg Fahrer

    Full Text Available Genetically engineered bacterial protein toxins are attractive systems for delivery of exogenous proteins into the cytosol of mammalian cells. The binary C2 toxin from C. botulinum has emerged as powerful delivery vehicle, which rests on its binding/translocation component C2IIa and the genetically modified adaptor domain C2IN that act in concert to trigger cell uptake. The p53 tumor suppressor protein has a crucial function in suppressing carcinogenesis and is frequently inactivated by diverse mechanisms in human tumor cells. Therefore, we constructed a C2IN-p53 fusion protein, which is internalized into cancer cells by C2IIa. To this end, the C2IN-p53 fusion construct was overexpressed in E. coli with good solubility, purified by heparin affinity chromatography and protein identity was confirmed by immunoblotting. We demonstrated that the fusion protein is capable of binding to the p53 consensus-DNA with high affinity in a p53-specific manner in vitro. Next, the internalization of C2IN-p53 was monitored in HeLa cells by cell fractionation and immunoblot analysis, which revealed a C2IIa-mediated translocation of the fusion protein into the cytosol. The uptake was also shown in A549 and Saos-2 cells with similar efficiency. These findings were further corroborated by confocal immunofluorescence analyses of C2IN-p53/C2IIa-treated HeLa and A549 cells, displaying predominantly cytoplasmic localization of the fusion construct.

  10. The Efficacy and Safety of Fractional CO2 Laser Combined with Topical Type A Botulinum Toxin for Facial Rejuvenation: A Randomized Controlled Split-Face Study

    Directory of Open Access Journals (Sweden)

    Jie Zhu

    2016-01-01

    Full Text Available Objective. We evaluated synergistic efficacy and safety of combined topical application of Botulinum Toxin Type A (BTX-A with fractional CO2 laser for facial rejuvenation. Methods. Twenty female subjects were included for this split-face comparative study. One side of each subject’s cheek was treated with fractional CO2 plus saline solution, and the other side was treated with fractional CO2 laser plus topical application of BTX-A. Patients received one session of treatment and evaluations were done at baseline, one, four, and twelve weeks after treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL, and the erythema and melanin index. Results. BTX-A combined with fractional CO2 laser sides showed higher physician’s global assessment score, subject satisfaction score, roughness, skin hydration, and skin elasticity compared to that of fractional CO2 plus saline solution side at 12 weeks after treatment. TEWL and erythema and melanin index showed no significant differences between two sides at baseline, one, four, and twelve weeks after treatment. Conclusion. Topical application of BTX-A could enhance the rejuvenation effect of fractional CO2 laser.

  11. Single treatments that have lasting effects: some thoughts on the antidepressant effects of ketamine and botulinum toxin and the anxiolytic effect of psilocybin.

    Science.gov (United States)

    Young, Simon N

    2013-03-01

    Recent clinical trials suggest that 3 single biological treatments have effects that persist. Based on research showing that the muscles involved in facial expressions can feed back to influence mood, a single trial diminishing glabella frown lines with botulinum toxin demonstrated a significant antidepressant effect for 16 weeks. Based primarily on research with animal models of depression suggesting that glutamate may be involved in depression, the N-methyl-D-aspartate antagonist ketamine has been tested in several trials. A single dose decreased depression for up to a week. The reported effects of the use of mushrooms containing psilocybin by a number of cultures around the world has stimulated several trials showing beneficial effects of a single dose of psilocybin for over a year in healthy people, and for up to 3 months in patients with anxiety disorders who have advanced cancer. This article discusses these studies, their rationale, their possible mechanisms of action, the future clinical research required to establish these therapies and the basic research required to optimize single treatments that have lasting effects.

  12. Benefícios da aplicação de toxina botulínica associada à fonoterapia em pacientes disfágicos graves Benefits of botulinum toxin associated to swallowing therapy in patients with severe dysphagia

    Directory of Open Access Journals (Sweden)

    Fernanda Teixeira Menezes

    2012-06-01

    Full Text Available Estudo de casos para caracterizar os benefícios da aplicação de toxina botulínica em glândulas salivares, associada à fonoterapia em pacientes disfágicos graves. Foram analisados cinco prontuários de pacientes neurológicos, em uso exclusivo de via alternativa de alimentação, com idades entre 17 e 70 anos, sendo quatro do gênero masculino e um do gênero feminino. Do total, quatro pacientes eram traqueostomizados. Foi considerado como critério de inclusão apresentar disfagia grave, com manifestações clínicas de escape extra oral e/ou acúmulo de saliva em cavidade oral e aspiração traqueal maciça de saliva, com limitação da fonoterapia. Quanto à avaliação clínica da deglutição, foram coletados dados pré e pós-fonoterapia associada à aplicação de toxina botulínica, quanto aos seguintes aspectos: mobilidade e força das estruturas orofaríngeas (lábios, língua, bochechas, elevação laríngea, grau da disfagia, uso de via alternativa de alimentação e traqueostomia. Quanto aos resultados pós- fonoterapia foi observado, em quatro pacientes, melhora da mobilidade e força de lábios, língua, bochechas e laringe. Quatro pacientes apresentaram deglutição funcional e um teve modificação do grau de gravidade da disfagia. Desta forma, a maioria foi capaz de receber dieta exclusiva por via oral e apenas um permaneceu com dieta mista, ou seja, gastrostomia e dieta via oral na consistência pastosa. Todos os pacientes traqueostomizados tiveram a cânula de traqueostomia removida. O estudo mostrou que o tratamento descrito acima contribui para a reabilitação da deglutição, reintrodução de alimentos por via oral e retirada da cânula de traqueostomia.Case report with the aim to characterize the benefits of botulinum toxin injection into salivary glands in association with swallowing therapy in patients with severe dysphagia. The medical records of five neurological patients (four male and one female, aged

  13. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS-II Study

    Directory of Open Access Journals (Sweden)

    Klemens Fheodoroff

    2015-04-01

    Full Text Available In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A treatment in 456 adults with post-stroke upper limb spasticity (ULS. Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001, contractures (soft tissue shortening [STS] (p = 0.006 and spasticity (p = 0.02 than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001, contracture (p < 0.0001, spasticity (p < 0.001 and shorter time since stroke (p = 0.001. Patients setting goals for pain were older (p = 0.01 with more contractures (p = 0.008. The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year vs. longer-term (>1 year post-stroke (80.0% vs. 79.2% or presence or absence of severe contractures (76.7% vs. 80.6%, although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  14. Clinical research on botulinum toxin type A combining rehabilitation training for the treatment of children cerebral palsy%肉毒杆菌毒素A辅助复健训练治疗儿童痉挛型脑瘫的疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴素英

    2011-01-01

    AIM: To observe the clinical effect of botulinum toxin type A combining rehabilita-tion for the treatment of children cerebral palsy METHODS: Thirty-two cases of children cere-bral palsy admitted to hospital from March 2009 to March 2011 were randomly divided into two groups, control group (n= 16) and treatment group (n= 16). The control group was given conventional rehabilitation training; the treatment group was also given injection of botulinum toxin A. The clinical effects in 2 groups were observed and compared. RESULTS: After treatment, the GMFM score in the treatment group was significantly higher than that in the control group (P<0. 05). The Ashworth score in the treatment group was significantly lower thanthat in the control group (P<0. 05); and the popliteal fossa angle, foot disaffection angle and abduction angle in the treatment group were superior to those in the control group (P<0. 05). CONCLUSION- There is a significant clinical effect of botulinum toxin type A combining rehabilitation for the treatment of children cerebral palsy.%目的:探讨采用肉毒杆菌毒素A辅助复健训练治疗儿童痉挛型脑瘫的临床疗效.方法:将本院2009年3月-2011年3月收治的32例脑性瘫痪患儿随机分成2组:对照组16例,试验组16例.其中,对照组给予常规的复健训练治疗,试验组则给予注射肉毒杆菌毒素A辅助复健训练治疗.结果:经过治疗后,试验组的粗大运动(GMFM)功能评分显著高于对照组(P<0.05);试验组的肌张力改良Ashworth评分相比对照组显著性降低(P<0.05);试验组的腘窝角、足背屈角、足外展角的活动范围相比对照组均有显著性改善(P<0.05).结论:采用肉毒杆菌毒素A辅助复健训练治疗儿童脑瘫的临床疗效显著.

  15. Toxina botulínica no tratamento da dor Toxina botulínica en el tratamiento del dolor Botulinum toxin in pain treatment

    Directory of Open Access Journals (Sweden)

    Orlando Carlos Gomes Colhado

    2009-06-01

    indicaciones, todavía están en fase de comprobación con relación a su eficacia. El objetivo de este estudio fue revisar el historial, las propiedades farmacológicas y las aplicaciones clinicas de la TxB, cuando se usa en el tratamiento de dolores de diferentes etiologías. CONTENIDO: La TxB es el producto de la fermentación del Clostridium Botulinum, una bacteria anaerobia Gram-positiva. Comercialmente, las TxB existen bajo las formas A y B, agentes biológicos obtenidos laboratorialmente. La TxB, una neurotoxina que posee una alta afinidad por las sinapsis colinérgicas, ocasiona un bloqueo en la liberación de acetilcolina por el terminal nervioso, sin alterar la conducción neural de las señales eléctricas o la síntesis y el almacenaje de acetilcolina. Se ha comprobado que la TxB puede debilitar selectivamente la musculatura dolorosa, interrumpiendo el ciclo espasmo-dolor. Con relación a él, varias publicaciones han demostrado la eficacia y la seguridad de la TxB-A en el tratamiento de la cefalea tipo tensión, migraña, dolor lumbar crónico y dolor miofacial. CONCLUSIONES: La TxB-A es segura y se tolera muy bien en los desórdenes dolorosos crónicos, donde los regímenes de farmacoterapia pueden de hecho provocar efectos colaterales. Otra ventaja es la reducción del uso de analgésicos y el tiempo de acción de 3 a 4 meses por dosis. Sin embargo, investigaciones futuras serán necesarias para establecer la eficacia de la TxB-A en los desórdenes dolorosos crónicos y su exacto mecanismo en el alivio del dolor, como también su potencial en tratamientos multifactoriales.BACKGROOUND AND OBJECTIVES: Botulinum toxin (BTX is one of the most potent bacterial toxins known and its effectiveness in the treatment of some pain syndromes is well known. However, the efficacy of some of its indications is still in the process of being confirmed. The objective of this study was to review the history, pharmacological properties, and clinical applications of BTX in the

  16. Botulinum toxin assessment, intervention and aftercare for paediatric and adult niche indications including pain: international consensus statement.

    Science.gov (United States)

    Rawicki, B; Sheean, G; Fung, V S C; Goldsmith, S; Morgan, C; Novak, I

    2010-08-01

    Evidence is emerging for the use of botulinum neurotoxin type-A (BoNT-A) for niche indications including pain independent of spasticity. Pain indications such as chronic nociceptive back pain, piriformis syndrome, chronic myofascial pain, pelvic pain, complex regional pain syndrome, facial pain and neuropathic pain are outlined in this paper. Of these, class I evidence is available for the treatment of chronic nociceptive low back pain, piriformis syndrome, myofascial pain, facial pain, neuropathic pain and plantar fasciitis. Peri-operative use of BoNT-A is emerging, with indications including planning for surgery and facilitating surgery, as well as healing and improving analgesia post-operatively. Evidence is limited, although there are some reports that clinicians are successfully using BoNT-A peri-operatively. There is class I evidence showing pre-operative use of BoNT-A has a beneficial effect on outcomes following adductor-release surgery. The use of BoNT for treatment of tremor, other than neck tremor in the setting of cervical dystonia, including evidence for upper limb tremor, cranial tremor and non-dystonic neck tremor is reviewed. The evidence is variable at this stage, and further study is required to develop definitive recommendations for the clinical utility of BoNT-A for these indications.

  17. Rating scales for cervical dystonia: a critical evaluation of tools for outcome assessment of botulinum toxin therapy.

    Science.gov (United States)

    Jost, Wolfgang H; Hefter, Harald; Stenner, Andrea; Reichel, Gerhard

    2013-03-01

    Botulinum neurotoxin is the therapy of choice for all forms of cervical dystonia (CD), but treatment regimens still vary considerably. The interpretation of treatment outcome is mainly based on the clinical experience and on the scientific value of the rating scales applied. The aim of this review is to describe the historical development of rating scales for the assessment of CD and to provide an appraisal of their advantages and drawbacks. The Tsui score and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) have been widely employed in numerous clinical studies as specific instruments for CD. The obvious advantage of the Tsui score is its simplicity so that it can be easily implemented in clinical routine. The TWSTRS allows a more sophisticated assessment of functional features of CD, but only the Tsui score includes a rating for tremor. Other benefits of the TWSTRS are the disability and pain subscales, but despite its value in clinical trials, it might be too complex for routine clinical practice. None of the rating scales used at present has been rigorously tested for responsiveness to detect significant changes in clinical status after therapeutic interventions. Moreover, clinical data support a new classification of CD leading to a differentiation between head and neck subtypes. As the current rating scales are not able to cover all these aspects of the disorder, further research is needed to develop a valid and reliable instrument which considers the most current classification of CD.

  18. A型肉毒毒素对脑性瘫痪患儿腘绳肌痉挛的疗效%Effect of Botulinum Toxin Type A on Spastic Hamstring in Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    刘建军; 席冰玉; 纪树荣; 吴卫红; 张雁; 曾凡勇; 李南玲

    2014-01-01

    目的:观察A型肉毒毒素(BTX-A)注射缓解脑瘫患儿腘绳肌痉挛的疗效。方法39例存在腘绳肌痉挛的脑瘫患儿分为对照组(n=20)和观察组(n=19),对照组采用常规康复训练,观察组在常规康复训练的基础上予BTX-A局部注射。治疗前后采用改良Ashworth量表(MAS)、粗大运动功能测试(GMFM-88)、膝关节屈曲角度进行评定。结果治疗6周后,观察组患儿腘绳肌MAS评分、膝关节屈曲角度、GMFM-88评分均较治疗前改善(P<0.05),且均优于对照组(P<0.05);对照组GMFM-88较治疗前改善(P<0.05)。结论 BTX-A注射可以有效缓解脑瘫患儿腘绳肌痉挛,有助于纠正异常步态,提高患儿运动功能。%Objective To observe the effect of Botulinum toxin type A (BTX-A) injection on spastic hamstring in the children with cere-bral palsy. Methods 39 cerebral palsy children with spastic hamstring were divided into control group (n=20) and experimental group (n=19). The control group accepted physical therapy, while the experimental group accepted BTX-A injection in affected hamstring in addition. They were assessed with modified Ashworth Scale (MAS), Gross Motor Fucntion Measure (GMFM-88) and flexion angle of knee joints be-fore and after treatment. Results The scores of MAS and GMFM-88, and flexion angle of knee joints improved significantly 6 weeks after treatment in the experimental group (P<0.05), and improved more than that in the control group (P<0.05). Only the score of GMFM-88 im-proved significantly in the control group (P<0.05). Conclusion BTX-A injection can relieve hamstring spasticity in children with cerebral palsy, which may be helpful to correct abnormal gait and improve the motor function.

  19. A型肉毒毒素对脑性瘫痪患儿腘绳肌痉挛的疗效%Effect of Botulinum Toxin Type A on Spastic Hamstring in Children with Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    刘建军; 席冰玉; 纪树荣; 吴卫红; 张雁; 曾凡勇; 李南玲

    2014-01-01

    Objective To observe the effect of Botulinum toxin type A (BTX-A) injection on spastic hamstring in the children with cere-bral palsy. Methods 39 cerebral palsy children with spastic hamstring were divided into control group (n=20) and experimental group (n=19). The control group accepted physical therapy, while the experimental group accepted BTX-A injection in affected hamstring in addition. They were assessed with modified Ashworth Scale (MAS), Gross Motor Fucntion Measure (GMFM-88) and flexion angle of knee joints be-fore and after treatment. Results The scores of MAS and GMFM-88, and flexion angle of knee joints improved significantly 6 weeks after treatment in the experimental group (P<0.05), and improved more than that in the control group (P<0.05). Only the score of GMFM-88 im-proved significantly in the control group (P<0.05). Conclusion BTX-A injection can relieve hamstring spasticity in children with cerebral palsy, which may be helpful to correct abnormal gait and improve the motor function.%目的:观察A型肉毒毒素(BTX-A)注射缓解脑瘫患儿腘绳肌痉挛的疗效。方法39例存在腘绳肌痉挛的脑瘫患儿分为对照组(n=20)和观察组(n=19),对照组采用常规康复训练,观察组在常规康复训练的基础上予BTX-A局部注射。治疗前后采用改良Ashworth量表(MAS)、粗大运动功能测试(GMFM-88)、膝关节屈曲角度进行评定。结果治疗6周后,观察组患儿腘绳肌MAS评分、膝关节屈曲角度、GMFM-88评分均较治疗前改善(P<0.05),且均优于对照组(P<0.05);对照组GMFM-88较治疗前改善(P<0.05)。结论 BTX-A注射可以有效缓解脑瘫患儿腘绳肌痉挛,有助于纠正异常步态,提高患儿运动功能。

  20. A型肉毒毒素治疗痉挛型脑瘫的研究进展%Research progress of botulinum toxin type A in treatment of spastic cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    刘春明(综述); 刘芸(审校)

    2015-01-01

    Cerebral palsy refers to brain injury caused by various reasons from before birth to 1 month after birth or movement disorders and abnormal posture caused by brain developmental defects. Children cerebral palsy is divided into 5 kinds in the clinic:spastic type, dyskinetic type, ataxia type, muscle hypotonia type and mixed type. Among them, the spastic type accounts for 60% ~70% , and is the main type which causes children physical disabilities. Once diagnosed, the comprehensive treatment method is ap-plied, including functional training, physical therapy, acupuncture, massage, medicine treatment, and so on. In recent years, the lo-cal injection of botulinum toxin A is used for treating the children with spastic cerebral palsy. A large number of clinical studies show that the drug is safe and effective; however, in the course of treatment, it should strictly control the drug indications and contraindica-tions. Especially, the dosage choice and the accurate localization of target muscle is the key factor to influence the treatment effect.%脑瘫是指出生前到出生后1个月内各种原因所引起的脑损伤或发育缺陷所致的运动障碍及姿势异常。小儿脑瘫临床上分为痉挛型,不随意运动型,共济失调型,肌张力低下型及混合型5种,其中,痉挛型占60%~70%,是造成儿童肢体残疾的最主要脑瘫类型。脑瘫一旦确诊多采用综合的治疗方法包括功能训练,物理疗法,中医针刺,按摩,药物治疗等。近年来,临床上开始广泛使用毒杆菌毒素 A(botuli-num toxin A,BTX-A)局部注射治疗痉挛型脑瘫儿童,大量临床研究结果显示该药安全、有效,但在治疗过程中应该严格掌握使用该药的适应证,禁忌证,而剂量的选择和靶肌的准确定位是影响治疗效果的关键因素。

  1. Application progress of botulinum toxin type A in the nervous system diseases%A型肉毒毒素在神经系统疾病中的应用研究进展

    Institute of Scientific and Technical Information of China (English)

    江伟; 何传斌

    2011-01-01

    In recent years, with the deepening study on the mechanism of botulinum toxin type A, the range of its applica -tions in the nervous system diseases continues to expand. Because botulinum toxin type A produces partial chemical dener-vation of the muscle resulting in a localized reduction in muscle activity, it can be used to treat hemifacial spasm, idio -pathic blepharospasm, oromandibular dystonia, spasmodic torticollis, tic disorder, limb spasticity after stroke and spastic cerebral palsy. In addition, it has recently begun to show some benefit in the control of hyperhidrosis ang excessive saliva -tion disease on account of its effects of the autonomic nervous system. It may also prove useful in treatment of a variety of headache and neuralgia owing to its analgesic effects. Therefore, botulinum toxin type A has become an important treatment option in the field of neurology.%近年来随着A型肉毒毒素作用机制研究的不断深入,其在神经系统疾病中的应用范围日渐扩大.因其肌肉化学性去神经支配效应可用于治疗面肌痉挛、特发性眼睑痉挛、口下颌肌张力障碍、痉挛性斜颈、抽动障碍、脑卒中后肢体痉挛和痉挛性脑瘫;因其植物神经系统效应可用于治疗多涎病症和多汗证;因其镇痛效应可用于治疗各种头痛和神经痛,故A型肉毒毒素已逐渐成为神经科领域一种重要的治疗手段.

  2. Application of botulinum toxin A in spasm of upper limbs after stroke:a review%A型肉毒毒素在治疗脑卒中后上肢痉挛中的应用

    Institute of Scientific and Technical Information of China (English)

    崔利华; 张通

    2005-01-01

    肉毒毒素(botulinum toxin, BTX)是治疗肌张力障碍和肌肉痉挛十分有效的药物.在我国,多应用于颜面部和颈部的肌肉痉挛.对于脑损伤后所致的肢体痉挛,我国应用这种方法治疗的情况并不多.本文就肉毒毒素治疗脑卒中后上肢痉挛的治疗应用进行综述.

  3. Toxina botulínica tipo A tópica con iontoforesis para el tratamiento de la hiperhidrosis axilar: Efecto y persistencia Topic type A botulinum toxin with iontophoresis in the treatment of armpit hyperhidrosis: effect and persistency

    Directory of Open Access Journals (Sweden)

    J.F. Silva-Gavarrete

    2011-09-01

    exocrine glands is termed Hyperhidrosis (HH and frequently become a dermatologic and social problem for humans. Nowadays, we have multiple treatments that controls the armpit HH. Botulinum toxin type A (TXB-A is known to be the best treatment to eliminate this problem but the needing of multiple injections in the armpit limits patients´ acceptance. Clinical iontophoresis method uses galvanic current to introduce many transdermal medications. We perform a simple blind clinical assay over 10 patients with armpit HH in who we apply an inert gel blended with Botulinum toxin type A (TXB-A Dysport® using one session of iontopheresis in one armpit; in the same moment the other armpit was injected with the toxin in the conventional way. The results where evaluated and compare by Minor Test (starch-iodine test in each patient at day 10th, 2 months and 5 months after the application. The same number of units and dilution of TXB-A where used in the topic and injected administration way. Results shows a diminished armpit HH in both sides over the whole study, been higher percentage of the effect in the injected way. In general a 74.67% decrease of armpit sweat for the topical way with iontopheresis and 90.33% of decrease of armpit sweat for the injected way. In the 5 months control of the persistency of the effect, both ways of administration of TXB-A reports with statistical significant results. Therefore in the present study we conclude that TXB-A apply topically with iontopheresis improves the armpit HH and shows a persistency of the effect at least for 5 months period.

  4. Toxina botunílica tipo B no manejo de distonia não-responsiva a toxina botunílica tipo A Botulinum toxin type B in the management of dystonia non-responsive to botulinum toxin type A

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    Francisco Cardoso

    2003-09-01

    sessões de 17,4 semanas (variação 16-18. Ela se tornou não-respondedora após a nona sessão. Primeiro tratamento com BTX-B, 6000U, recebeu escore 0. A segunda sessão, 12000U, produziu escore 4.Paciente 4- Com a idade de 69 anos este homem desenvolveu distonia cranial idiopática. Antes de ser atendido por mim, ele recebeu 6 sessões de BTX-A em outros serviços. Na minha instituição ele foi tratado com dose acumulada de 730U em 4 sessões com intervalo médio entre sessões de 16,3 semanas (variação 15-18, havendo perdido a resposta na sexta sessão. Tratamento com BTX-B, 12000U, produziu escore 4 e durou 20 semanas. Efeitos colaterais: dor local (todos os pacientes e ressecamento da boca e ptose palpebral (um paciente cada. CONCLUSÃO: Meus achados confirmam que injeções de BTX-B são eficazes e seguras para pacientes não-respondedores secundários a BTX-A. Os resultados também mostram ser necessário individualizar a dose de BTX-B para se alcançar melhores resultados.BACKGROUND: Botulinum toxin (BTX injection is the first choice treatment for focal dystonias. However 10% or more of patients who receive repetitive injections of BTX type A (BTX-A lose response (secondary non-responders. One of the strategies to manage such patients is to treat them with another serotype. The aim of this article is to describe my experience with BTX type B (BTX-B in the management of patients with focal dystonia who became secondary non-responders to BTX-A. METHOD: Open-label non-controlled use of BTX-B injections to treat dystonia patients who developed secondary nonresponse to BTX-A Response to treatment was rated on a 0-4 scale (Jankovic. RESULTS: Four patients entered the study. Pacient 1- At age 48 this man developed idiopathic cervical dystonia. Five years later he also presented with blepharospasm and idiopathic oromandibular dystonia. He was treated with 7604U of BTX-A along 23 sessions separated by a mean interval of 18.8 weeks (range 6-39. Loss of response was

  5. Botulinum toxin type A in the treatment of hemifacial spasm: an 11-year experience Toxina botulínica tipo A no tratamento do espasmo hemifacial: 11 anos de experiência

    Directory of Open Access Journals (Sweden)

    Egberto Reis Barbosa

    2010-08-01

    Full Text Available In order to evaluate the long-term effect of botulinum toxin type A (BTX in the treatment of hemifacial spasm (HFS, a retrospective analysis of patients treated at the Movement Disorders Unit of the Division of Neurology, Clinical Hospital, University of São Paulo, School of Medicine from 1993 to 2004 was made. A total of 808 injections with BTX were administered to 54 patients with HFS. The mean duration of improvement per application was 3.46 months and the mean rate of improvement using subjective judgement by the patient was of 83%. Adverse effects, mostly minor, were observed in 64.8% of patients at least once along the period of follow-up and the most frequent of them was orbicularis oris paralysis (38.8%. There was no decrement in response when compared the first and the last injection recorded.Para avaliar o efeito em longo prazo da toxina botulínica tipo A (TXB no tratamento do espasmo hemifacial (EHF, foi feita uma análise retrospectiva de pacientes tratados no Ambulatório de Distúrbios do Movimento da Divisão de Clínica Neurológica - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no período de 1993 a 2004. Um total de 808 aplicações de TXB foram administradas a 54 pacientes com EHF. A duração média de melhora foi de 3,46 meses e a taxa média de melhora segundo avaliação subjetiva do paciente foi de 83%. Efeitos adversos, em sua maioria menores, foram observados em 64,8% dos pacientes ao menos uma vez durante o seguimento e o mais freqüente foi paralisia do orbicular da boca (38,3%. Não se observou decremento na resposta quando se comparou a primeira com a última aplicação anotada.

  6. Treatment of scar contracture with intralesional botulinum toxin type A : a preliminary research%A型肉毒毒素治疗挛缩性瘢痕的初步研究

    Institute of Scientific and Technical Information of China (English)

    颜彤彤; 陈敏亮; 马奎; 孙同柱; 梁黎明; 刘畅; 赖林英; 付小兵

    2013-01-01

    Objective: To evaluate the effect and mechanism of botulinum toxin type A (BTXA) in treating scar contracture. Methods: Ten patients with typical contractive scars were involved in this study. Two independent scars (area <10 cm2) of each patient were selected and were randomly divided into BTXA group (receiving intralesional injection of BTXA for 2 times trimonthly) , and blank control group (receiving the same volume of normal saline). Before and 1,3,6 months after BTXA injection, the length of the longest axis of the scar was measured to reflect the changes in scar contracture. The scar tissues from 5 patients undergoing excision of scar 6 months after BTXA injection were observed with HE staining by light microscopy, and the expression of α-smooth muscle actin (α-SMA) and myosin-Ⅱ were assayed by immunohistochemical method. Results: The degree of scar contraction was lessened in BTXA group compared with that of control group (P<0. 01) , especially 6 months after the first injection [(1. 103 ± 0. 158)cm vs. (0. 187 ± 0. 221)cm]. The collagen was sparse and better aligned, and the number of fibroblasts was significantly reduced at the BTXA injection area. The expression of α-SMA and myosin-Ⅱ also decreased in BTXA group(P<0. 01). Conclusion: The results show that BTXA injections is safe and effective in treating contractive scars. The mechanism maybe attributable to a reduction of the expression of a-SMA and myosin- Ⅱ of fibroblasts in scars.%目的:探讨A型肉毒毒素(BTXA)治疗挛缩性瘢痕的效果及其作用机制.方法:10例烧伤后挛缩性瘢痕患者,每人选取两处挛缩性瘢痕,随机分为BTXA组(瘢痕内注射BTXA,间隔3个月1次,共2次)和空白对照组(瘢痕内注射等积生理盐水),于注射前及首次注射后1、3、6个月测量瘢痕长轴长度,观察其长度变化用以反映瘢痕挛缩程度;切取5例药物治疗6个月后行瘢痕切除手术患者的瘢痕组织,HE染色观察病理学改变,免疫组

  7. Botulinum Neurotoxin A Injections Influence Stretching of the Gastrocnemius Muscle-Tendon Unit in an Animal Model

    Directory of Open Access Journals (Sweden)

    Christopher J. Tuohy

    2012-08-01

    Full Text Available Botulinum Neurotoxin A (BoNT-A injections have been used for the treatment of muscle contractures and spasticity. This study assessed the influence of (BoNT-A injections on passive biomechanical properties of the muscle-tendon unit. Mouse gastrocnemius muscle (GC was injected with BoNT-A (n = 18 or normal saline (n = 18 and passive, non-destructive, in vivo load relaxation experimentation was performed to examine how the muscle-tendon unit behaves after chemical denervation with BoNT-A. Injection of BoNT-A impaired passive muscle recovery (15% vs. 35% recovery to pre-stretching baseline, p < 0.05 and decreased GC stiffness (0.531 ± 0.061 N/mm vs. 0.780 ± 0.037 N/mm, p < 0.05 compared to saline controls. The successful use of BoNT-A injections as an adjunct to physical therapy may be in part attributed to the disruption of the stretch reflex; thereby modulating in vivo passive muscle properties. However, it is also possible that BoNT-A injection may alter the structure of skeletal muscle; thus modulating the in vivo passive biomechanical properties of the muscle-tendon unit.

  8. Digital Image Speckle Correlation for the Quantification of the Cosmetic Treatment with Botulinum Toxin Type A (BTX-A)

    Science.gov (United States)

    Bhatnagar, Divya; Conkling, Nicole; Rafailovich, Miriam; Dagum, Alexander

    2012-02-01

    The skin on the face is directly attached to the underlying muscles. Here, we successfully introduce a non-invasive, non-contact technique, Digital Image Speckle Correlation (DISC), to measure the precise magnitude and duration of facial muscle paralysis inflicted by BTX-A. Subjective evaluation by clinicians and patients fail to objectively quantify the direct effect and duration of BTX-A on the facial musculature. By using DISC, we can (a) Directly measure deformation field of the facial skin and determine the locus of facial muscular tension(b)Quantify and monitor muscular paralysis and subsequent re-innervation following injection; (c) Continuously correlate the appearance of wrinkles and muscular tension. Two sequential photographs of slight facial motion (frowning, raising eyebrows) are taken. DISC processes the images to produce a vector map of muscular displacement from which spatially resolved information is obtained regarding facial tension. DISC can track the ability of different muscle groups to contract and can be used to predict the site of injection, quantify muscle paralysis and the rate of recovery following BOTOX injection.

  9. Toxina botulínica no blefaroespasmo, no espasmo hemifacial e na distonia cervical: resultados em 33 pacientes Botulinum toxin in blepharospasm, hemifacial spasm and cervical dystonia: results in 33 patients

    Directory of Open Access Journals (Sweden)

    Sérgio Ap. Novis

    1995-09-01

    of the dystonic movements, before and two weeks after each injection. Among blepharospasm patients, eight were female and four were male; the mean age was 57.7 years; the mean time of the disease duration was four years. Three had familial history for similar disease; nine were essential and three had used neuroleptic drugs (tardive dystonia. The mean dose used was 51.3 U, with a mean time of benefical effects of 2.8 months. For 22 injections and reinjections, 14 (63.7% showed an excellent result, five (22.7% good and three (13.6% null. In the hemifacial spasm group, eight were female and two male; the mean age was 52.6 years; the mean time of the disease duration was 7.4 years; eight were essential and two post-paralytic. The mean dose used was 32 U. From the total of 15 injections and reinjections, all of them (100% had an excellent result, with a mean time of benefical effect of 3.4 months. Among the cervical dystonic patients, eight were male and three female; the mean age was 44.2 years; the mean time of the disease duration was 12.2 years; six had essential dystonia, three had used neuroleptic drugs and two had familial history for similar disease. The mean dose used was 238.6 U, with the mean duration of effect of 3.5 months. From the total of 20 injections and reinjections, 18 (90% had good result, one (5% mild and one (5% null. Ptosis, facial palsy and dysphagia were the most common side effects seen. We conclude that botulinum toxin is effective for the treatment of such disorders.

  10. Botulinum toxin type A in refractory chronic migraine: an open-label trial Toxina botulínica tipo A no tratamento da enxaqueca refratária: um estudo aberto

    Directory of Open Access Journals (Sweden)

    Carla Menezes

    2007-09-01

    Full Text Available Botulinum toxin type A (BT-A has been described as an important strategy to various types of pain such as cervical dystonia, myofascial pain syndrome and headache. Although BT-A efficacy has not been proven in tension type headache, its use in migraine continues controversial. In this open trial, we evaluated the efficacy of BT-A in refractory migraine. BT-A was injected in patients diagnosed with migraine who had previously used three classes of prophylactic drugs by at least one year with no response. The most important improvement was observed within 30 days, but pain intensity and frequency of headache had been decreased until the end of three months of follow up. Side effects of BT-A were mild and self limited. We conclude that BT-A seems to be a safe and effective treatment to refractory migraine patients.Toxina botulínica tipo A (TB-A tem sido descrita como importante estratégia para diversos tipos de dor como cefaléia e dores relacionadas a distonia cervical ou síndrome miofascial. Embora a eficácia da TB-A não tenha sido demonstrada na cefaléia do tipo tensional, seu uso na enxaqueca continua controverso. Nesse estudo avaliamos a eficácia da TB-A na enxaqueca refratária. TB-A foi injetada em pacientes com enxaqueca que fizeram tratamento prévio com no mínimo três classes de medicamentos profiláticos, sem resultados satisfatórios. A melhora mais significativa dos pacientes foi observada após 30 dias de aplicação de TB-A, enquanto intensidade da dor e freqüência de cefaléia continuaram reduzidas até o final de três meses de seguimento. Os efeitos colaterais observados após a aplicação de TB-A foram moderados e auto-limitados. Os nossos dados mostram que TB-A parece ser um tratamento seguro e eficaz para pacientes com enxaqueca refratária.

  11. 两种A型肉毒毒素在前额的弥散性比较%Diffuseness comparison of two kinds of botulinum toxins type A on the forehead

    Institute of Scientific and Technical Information of China (English)

    姜海燕; 陈淑君; 周珺

    2016-01-01

    Objective To evaluate the diffuse characteristics of two types of botulinum toxin type A (BOTOX and CBTX A) in the forehead and the effect of intradermal (ID) and subcutanous (SC) infections on their diffusion.Methods Healthy volunteers (n =20) were recruited to receive a 0.05 ml (2 U) injection of botulinum toxin type A at four forehead sites [both sides of medial forehead (SC) and temporal forehead (ID)],one side for BOTOX and another for CBTX-A.On day 14,the Minors' iodine starch test was performed and photographs were taken for calculating the area and dimensions of anhydrotic area.Results The areas of anhidrosis ID were significantly greater with CBTX-A (180±15) mm2 than that of BOTOX (144±14) mm2.The same conditions occurred in vertical dimensions (14.4±1.1) mm vs.(15.8±1.0) mm and horizontal dimensions (10.8±0.6) mm vs.(12.5±0.7) mm.There was significant variation between the both for diffuseness in the two anhidrotic halos observed after ID injection (P<0.05).The areas of anhidrosis by SC were significantly greater with CBTX-A (207±17) mm2 than that in BOTOX (183±18) mm2.The mean horizontal dimension was greater with CBTX-A by SC (13.2±0.6) mm than that of BOTOX by SC (12.2±0.7) mm,but not statistically significant (P =0.06).The mean horizontal dimension in BOTOX was significantly greater with SC than that with ID (P<0.05).There was no statistically significant difference between SC and ID administration of CBTX-A.Conclusions BOTOX diffuses less than CBTX-A.ID injection technique may result in less diffusion than SC.%目的 探讨两种注射用A型肉毒毒素(保妥适和衡力)在前额的弥散性,以及皮内注射和皮下注射对药物弥散性的影响.方法 选取健康志愿者20名,在前额4个部位分别注射0.05 ml(2 U)的A型肉毒毒素.随机选择在一侧前额的中部和颞侧注射保妥适,而在另一侧前额的中部和颞侧注射衡力;其中前额中部行皮下注射,颞侧行皮内注射.注射后第14天进

  12. The analgesic effects of intra-articular botulinum toxin type A and mechanisms in chronic knee arthritis pain model%A型肉毒杆菌毒素对佐剂关节炎大鼠的镇痛作用

    Institute of Scientific and Technical Information of China (English)

    茹靖涛; 曹靖; 秦涛

    2012-01-01

    目的 观察关节腔内注射A型肉毒杆菌毒素(BoNT/A)在佐剂关节炎模型中的镇痛效果及疼痛相关物质在脊神经节及脊髓的变化.方法 SD大鼠右后足跖部皮下注射完全弗氏佐剂(CFA)0.1 ml建立类风湿性关节炎的动物模型(AA).关节炎形成后随机分为3组:BoNT组(n=10):关节腔内注射Botox/A 0.02 IU/5μl;NS组(n=10):关节腔内注射生理盐水5μl;Sham组(n=10):非关节炎模型组.5d后检测疼痛行为学、力量评估;免疫组织化学检测脊神经节钠离子通道1.8(Nav1.8)、脊髓N-甲基-D-天冬氨酸受体2B亚基(NR2B)的表达.结果 肉眼步态分析显示大鼠关节炎引起的严重的步态异常,BoNT治疗组改善了40% (P <0.05);治疗组大鼠右足热痛阈升高(P<0.05);脊神经节Nav1.8高表达;脊髓NR2B表达降低.结论 通过关节腔内注射Botox/A可以抑制疼痛信号的传导,减轻关节痛.%Objective To estimate the analgesic effect of intra-articular injection of botulinum toxin type A (BoNT/A) in adjuvant arthritis model and to explore the related factors associated with arthritis pain.Methods We established murime model of chronic knee arthritis pain by injection of complete Freund's adjuvant (CFA) 0.1 ml into the right paw of Sprague Dawley rats.Following induction of arthritis,BoNT/A group (n =10) received intra-articular BoNT/A0.02 IU/5 μL; NS group (n =10) was treated with intra-articular 5 μL saline injections.In Sham group (n =10),no artiritis model was established.Pain behavior testing was performed prior to arthritis,after induction of arthritis,and following treatments.Pain behavior measures included analysis of gait impairment and thermal pain threshold.Strength was measured as ability to cling.Pain related factors Nav1.8 and NR2B were detected by using immunohistochemistry.Results Gait analysis showed that significant impairment of gait in arthritic mice wast improved by 40% ( P < 0.05 ) after intra-articular Bo

  13. Efectos de la toxina botulínica A (Botox® intraarticular en la artrosis de rodilla avanzada Effects of intraarticular Botulinum Toxin A (Botox® on refractory knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    P. Fenollosa Vázquez

    2011-12-01

    Full Text Available Objetivos: la osteoartritis es la enfermedad articular más común y una de los problemas de salud más frecuentes y sintomáticos en la madurez y senectud. Este trabajo describe nuestra experiencia clínica con inyecciones intraarticulares de toxina botulínica tipo A (TBA en dolor de rodilla artrósico y refractario. Materiales y métodos: doce mujeres con gonartrosis avanzada y refractaria, acudieron a consulta para el manejo del dolor de rodilla de moderado a severo. Las pacientes estuvieron en seguimiento 16 semanas, durante las que la mejoría de su estado fue valorado comparando el dolor basal respecto al dolor en el momento de la visita mediante diferentes escalas estandarizadas. Simultáneamente, se evaluaron la funcionalidad, la cantidad de medicación analgésica diaria y los efectos secundarios. Resultados: el consumo de medicación decreció de 3,6 a 2 tomas/día. No se observaron efectos secundarios. Conclusión: se evidenció un alivio del dolor que se inició en la semana 2 y se mantuvo hasta 12 semanas tras la inyección de TBA. La mediana del cambio de la escala total de WOMAC y de la EVA fue de -7,5 y -1,9 respectivamente, con una disminución significativa del dolor a las 16 semanas. No se registraron cambios en la escala WOMAC en 5 pacientes, mientras que 3 casos mostraron un descenso en dicha escala mayor del 20% y los en los 4 restantes fue superior al 40%. Las que respondieron a la infiltración notaron una mejora en las actividades de la vida diaria gracias a este alivio. El consumo de medicación decreció de 3,6 a 2 tomas/día. No se observaron efectos secundarios.Objective: osteoarthritis is the most common joint disease and it is among the most disabling health problems for middle aged and older people. Purpose: to test the effects of a single intraarticular injection of Botulinum Toxin A (BTA on refractory knee osteoarthritis. Material and method: twelve women (mean age: 72 with refractory knee osteoarthritis who

  14. Bioterrorism: toxins as weapons.

    Science.gov (United States)

    Anderson, Peter D

    2012-04-01

    The potential for biological weapons to be used in terrorism is a real possibility. Biological weapons include infectious agents and toxins. Toxins are poisons produced by living organisms. Toxins relevant to bioterrorism include ricin, botulinum, Clostridium perfrigens epsilson toxin, conotoxins, shigatoxins, saxitoxins, tetrodotoxins, mycotoxins, and nicotine. Toxins have properties of biological and chemical weapons. Unlike pathogens, toxins do not produce an infection. Ricin causes multiorgan toxicity by blocking protein synthesis. Botulinum blocks acetylcholine in the peripheral nervous system leading to muscle paralysis. Epsilon toxin damages cell membranes. Conotoxins block potassium and sodium channels in neurons. Shigatoxins inhibit protein synthesis and induce apoptosis. Saxitoxin and tetrodotoxin inhibit sodium channels in neurons. Mycotoxins include aflatoxins and trichothecenes. Aflatoxins are carcinogens. Trichothecenes inhibit protein and nucleic acid synthesis. Nicotine produces numerous nicotinic effects in the nervous system.

  15. Observation of Curative Effect to Type A Botulinum Toxin for Treatment of Hypertrophy of the Masseter%A型肉毒素治疗咬肌肥大25例疗效观察

    Institute of Scientific and Technical Information of China (English)

    朱倩; 黄巡

    2006-01-01

    目的:寻求保守治疗咬肌肥大的有效方法.方法:采用A型肉毒素(botulinum toxin type-A,BTX-A)对25例咬肌肥大的患者进行治疗,每一侧注射剂量为50U.结果:25例治疗均有效,其中4例出现不对称,经过追加调整剂量后,效果满意,25例均无并发症.结论:A型肉毒素治疗咬肌肥大是一种安全有效的保守方法,远期疗效尚需进一步观察.

  16. TYPE A BOTULINUM TOXIN IN COMBINATION WITH HYALURONIC ACID IN EYE WEEK YOUNGER CURATIVE EFFECT OBSERVATION OF TREATMENT%A型肉毒素联合透明质酸在眼周年轻化的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵冰冰

    2015-01-01

    Objective To observe the type A botulinum toxin in eye week younger treatment combined the effect of hyaluronic acid. SelectionMethods Our hospital from March 2013 to March 2013 were 78 patients with facial wrinkles, and duration were observed.Results 78 cases of patients with, and follow-up of patients after half a year has 100% efficient. Conclusion Type A botulinum toxin in combination with hyaluronic acid for the treatment of facial wrinkles, and has less traumatic, had A higher safety, suitable for popularization and application in clinic.%目的:观察在眼周年轻化治疗中A型肉毒素联合透明质酸的效果。方法选取我院在2013年3月至2015年3月收治的面部皱纹患者78例,患者都给予A型肉毒素联合透明质酸进行注射治疗,对治疗后的效果、不良反应发生率及持续时间进行观察。结果78例患者的皱纹处在治疗后改善明显,并且在半年后对患者进行随访,具有100%的有效率。结论 A型肉毒素联合透明质酸对于治疗面部动静态皱纹,具有微创、安全、快捷,适合在有面部年轻化愿望的求美者中推广应用。

  17. A型肉毒杆菌毒素的壳聚糖/海藻酸钠缓释微囊研制和药物的体外释放速率研究%The Study In Vitro Release Rate Study of Botulinum Toxin type A Chitosan/Alginate Microcapsules Using Research and Drugs

    Institute of Scientific and Technical Information of China (English)

    吴河坪; 林小铭; 曾明兵; 陈静嫦

    2015-01-01

    目的:研制包裹A型肉毒杆菌毒素的壳聚糖/海藻酸钠微囊,并测定其体外药物释放动力学。方法:采用注射器滴注法制成包裹A型肉毒杆菌毒素的壳聚糖/海藻酸钠微囊混悬液。采用高效液相色谱法测定A型肉毒杆菌毒素的标准曲线,每隔2周测定微囊所包裹的A型肉毒杆菌毒素体外释放浓度。结果:微囊形态为圆形透明颗粒状,粒径在1mm左右。用SPSS统计软件进行分析微囊中A型肉毒杆菌毒素的体外每2周释放量,显示药物累积释放量与时间之间为直线关系,基本符合药物零级释放动力学。结论:滴注法制备包裹A型肉毒杆菌毒素的壳聚糖/海藻酸钠缓释微囊制作方法简便,其药物体外释放稳定。%Objective:To develop parcels of botulinum toxin type A chitosan/alginate and tested for in vitro drug release kinetics. Method:using a syringe infusion into the legal package botulinum toxin type A chitosan/alginate suspension. Determination of botu-linum A toxin standard curve, two weeks entrapped microcapsules measured botulinum toxin type A in vitro release every concentra-tion using high performance liquid chromatography. Results: The microcapsules form a circular transparent granular diameter of about 1mm. Using SPSS statistical software for analysis microcapsules A botulinum toxin in vitro release every two weeks, show cumu-lative drug release and the time between a linear relationship, in line with the zero-order release kinetics of drugs. Conclusion:chito-san infusion prepared package of botulinum toxin type A/alginate microcapsules using the production method is simple, its in vitro drug release and stability.

  18. Time Course Analysis of the Effects of Botulinum Neurotoxin Type A on Pain and Vasomotor Responses Evoked by Glutamate Injection into Human Temporalis Muscles

    Directory of Open Access Journals (Sweden)

    Larissa Bittencourt da Silva

    2014-02-01

    Full Text Available The effect of botulinum neurotoxin type A (BoNTA on glutamate-evoked temporalis muscle pain and vasomotor responses was investigated in healthy men and women over a 60 day time course. Subjects participated in a pre-BoNTA session where their responses to injection of glutamate (1 M, 0.2 mL and saline (0.2 mL into the temporalis muscles were assessed. On Day 1, BoNTA (5 U was injected into one temporalis muscle and saline into the contralateral temporalis muscle, in a randomized order. Subjects then received intramuscular injections of glutamate (1 M, 0.2 mL into the left and right temporalis muscles at 3 h and subsequently 7, 30 and 60 days post-injection of BoNTA. Pain intensity, pain area, and neurogenic inflammation (skin temperature and skin blood perfusion were recorded. Prior to BoNTA treatment, glutamate evoked significantly greater pain and vasomotor reactions (P < 0.001 than saline. BoNTA significantly reduced glutamate-evoked pain intensity (P < 0.05, pain area (P < 0.01, skin blood perfusion (P < 0.05, and skin temperature (P < 0.001. The inhibitory effect of BoNTA was present at 3 h after injection, peaked after 7 days and returned to baseline by 60 days. Findings from the present study demonstrated a rapid action of BoNTA on glutamate-evoked pain and neurogenic inflammation, which is in line with animal studies.

  19. Análise vocal em pacientes com disfonia espasmódica nos momentos pré e pós tratamento com toxina Botulínica A Vocal analysis in patients with spasmodic dysphonia before and after treatment with Botulinum toxin A

    Directory of Open Access Journals (Sweden)

    Ana Cristina Côrtes Gama

    2012-10-01

    the parameters. CONCLUSION: there was significant improvement of the vocal analysis after treatment and, therefore, injections of botulinum toxin A were effective in the treatment of spasmodic dysphonia in this group.

  20. Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

    Directory of Open Access Journals (Sweden)

    Eduardo Cardoso

    2007-09-01

    Full Text Available Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI, Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (pEspasticidade secundária a acidente vascular cerebral (AVC é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses

  1. Cholera Toxin B Subunit Shows Transneuronal Tracing after Injection in an Injured Sciatic Nerve.

    Directory of Open Access Journals (Sweden)

    Bi-Qin Lai

    Full Text Available Cholera toxin B subunit (CTB has been extensively used in the past for monosynaptic mapping. For decades, it was thought to lack the ability of transneuronal tracing. In order to investigate whether biotin conjugates of CTB (b-CTB would pass through transneurons in the rat spinal cord, it was injected into the crushed left sciatic nerve. For experimental control, the first order afferent neuronal projections were defined by retrograde transport of fluorogold (FG, a non-transneuronal labeling marker as an experimental control injected into the crushed right sciatic nerve in the same rat. Neurons containing b-CTB or FG were observed in the dorsal root ganglia (DRG at the L4-L6 levels ipsilateral to the tracer injection. In the spinal cord, b-CTB labeled neurons were distributed in all laminae ipsilaterally between C7 and S1 segments, but labeling of neurons at the cervical segment was abolished when the T10 segment was transected completely. The interneurons, distributed in the intermediate gray matter and identified as gamma-aminobutyric acid-ergic (GABAergic, were labeled by b-CTB. In contrast, FG labeling was confined to the ventral horn neurons at L4-L6 spinal segments ipsilateral to the injection. b-CTB immunoreactivity remained to be restricted to the soma of neurons and often appeared as irregular patches detected by light and electron microscopy. Detection of monosialoganglioside (GM1 in b-CTB labeled neurons suggests that GM1 ganglioside may specifically enhance the uptake and transneuronal passage of b-CTB, thus supporting the notion that it may be used as a novel transneuronal tracer.

  2. Quality of life of children with cerebral palsy treated with botulinum toxin: are well-being measures appropriate? Qualidade de vida em crianças com paralisia cerebral tratadas com toxina botulínica: estas avaliações são adequadas?

    OpenAIRE

    Taísa R. Simões de Assis; Edilson Forlin; Isac Bruck

    2008-01-01

    AIM: To analyze quality of life (QOL) of children with cerebral palsy (CP) treated with botulinum toxin type A (BTXA). METHOD: Two QOL evaluation tools, translated into Portuguese, were used: Pediatric Outcomes Data Collection Instrument (PODCI) and Child's Caregiver Questionnaire (CCQ). Questionnaires were answered by caregivers on two occasions. Patients were divided into 3 groups: I - patients who had been previously treated with BTXA and who underwent a session of BTXA; II - patients who ...

  3. Botulinum toxin A and physiotherapy intervention in the treatment of the painful shoulder after stroke: case report
    Toxina botulínica A e intervenção fisioterapêutica no tratamento do ombro doloroso pós acidente vascular cerebral: relato de caso

    OpenAIRE

    Suellen M. Marinho dos Santos Andrade; Mayara Dinamine França Dantas; Cristina Katya Dantas Torres; Karen Lúcia de Araújo Freitas Moreira

    2007-01-01

    The syndrome of the painful shoulder is considered a common finding in patients who suffered stroke. Several therapeutic modalities are suggested for the improvement of the patients’ clinical condition. In this report, a case of syndrome of the painful shoulder will be discussed, whose treatment consisted of the use of botulinum toxin A associated to physiotherapy. After a four-month treatment, significant improvements occurred concerning pain, spasticity, range of motion and quality of life,...

  4. Botulinum Neurotoxin Type A in Neurology: Update

    OpenAIRE

    Orsini, Marco; Leite, Marco Antonio Araujo; Chung, Tae Mo; Bocca, Wladimir; de Souza, Jano Alves; de Souza, Olivia Gameiro; Moreira, Rayele Priscila; Bastos, Victor Hugo; Teixeira, Silmar; Oliveira, Acary Bulle; Moraes, Bruno da Silva; Matta, André Palma; Jacinto, Luis Jorge

    2015-01-01

    This paper reviews the current and most neurological (central nervous system, CNS) uses of the botulinum neurotoxin type A. The effect of these toxins at neuromuscular junction lends themselves to neurological diseases of muscle overactivity, particularly abnormalities of muscle control. There are seven serotypes of the toxin, each with a specific activity at the molecular level. Currently, serotypes A (in two preparations) and B are available for clinical purpose, and they have proved to be ...

  5. Treating benign prostatic hyperplasia with botulinum neurotoxin.

    Science.gov (United States)

    Brisinda, G; Vanella, S; Marniga, G; Crocco, A; Maria, G

    2011-01-01

    Botulinum toxin (BoNT) has been increasingly used in the interventional treatment of several disorders; the use of this agent has extended to a plethora of conditions including focal dystonia, spasticity, inappropriate contraction in most gastrointestinal sphincters, eye movement disorders, hyperhidrosis, genitourinary disorders and aesthetically undesirable hyperfunctional facial lines. In addition, BoNT is being investigated for the control of pain, and for the management of tension or migraine headaches and myofascial pain syndrome. Benign prostatic hyperplasia (BPH) is a common condition in ageing men; the goal of therapy is to reduce the lower urinary tract symptoms (LUTS) associated with BPH and to improve the quality of life. However, medical treatment, including drugs that relax smooth muscle within the prostate and drugs that shrink the gland are not totally effective or without complications. The standard surgical treatment for BPH is progressively changing to minimally invasive therapies, but none of them has provided clear results. The use of BoNT-A to inhibit the autonomic efferent effects on prostate growth and contraction, and inhibit the abnormal afferent effects on prostate sensation, might be an alternative treatment for BPH. BoNT injections have several advantages over drugs and surgical therapies in the management of intractable or chronic disease; systemic pharmacologic effects are rare, permanent destruction of tissue does not occur, and graded degrees of relaxation may be achieved by varying the dose injected. In this paper, clinical experience over the last years with BoNT in BPH impaired patients will be illustrated.

  6. The therapeutic effect comparative study of botulinum toxin A and baclofen in hemifacial spasm%A型肉毒毒素与巴氯芬治疗偏侧面肌痉挛的疗效对比

    Institute of Scientific and Technical Information of China (English)

    辛晋敏

    2012-01-01

    Objective To compare the therapeutic effect of local injection of botulinum toxin A (BTXA) and oral baclofen in hemifacial spasm (HFS).Methods Sixty-six patients with HFS were divided into BTXA treatment group (33 patients) and baclofen treatment group (33 patients) by random digits table.The patients in BTXA treatment group was given local multipoint target muscle injection of BTXA,and the patients in baclofen treatment group was given oral baclofen.The therapeutic effect was assessed after treatment of 2 weeks and 4 weeks.Results The scores of spasticity before treatment had no significant difference between two groups (P > 0.05).After treatment of 2 weeks and 4 weeks,the scores of spasticity in BTXA treatment group and baclofen treatment group were significantly decreased [BTXA treatment group:(1.80 ±0.70),(1.57 ± 0.17) scores vs.(3.15 ±0.43) scores;baclofen treatment group:(2.14 ±0.60),(1.14 ± 0.70) scores vs.(3.00 ± 0.48) scores] (P < 0.01).The scores of spasticity in BTXA treatment group after treatment of 2 weeks and 4 weeks were significantly lower than those in baclofen treatment group (P <0.05 or <0.01).After treatment of 4 weeks,the grades of spasticity between two groups had significant difference (P <0.05).The rate of adverse reaction in BTXA treatment group [15.15% (5/33)] was significantly lower than that in baclofen treatment group [51.52% (17/33)] (P < 0.01).Conclusions Local injection of BTXA and low dose oral baclofen in treatment of HFS can reach the obvious relief.But BTXA treatment has rapid onset,Iess adverse reaction and high compliance of the patients,and also symptoms improve more completely after BTXA treatment.BTXA can be used as preferred method of treating HFS.%目的 比较局部注射A型肉毒毒素(BTXA)与口服巴氯芬治疗偏侧面肌痉挛(HFS)的效果.方法 将2010年7月至2012年6月确诊HFS患者66例按随机数字表法分为BTXA治疗组和巴氯芬治疗组,对BTXA治疗组33例患者进行

  7. THE TREATMENT FOR UPPER HALF-FACE CREASES WITH THE BOTULINUM TOXIN A%A型肉毒毒素在上半面部除皱中的应用

    Institute of Scientific and Technical Information of China (English)

    杨卫国; 印强

    2002-01-01

    使用A型肉毒毒素(Botulinum Toxin A,BTX-A)注射治疗上半面部皱纹144例,其中额纹57例,眉间纹29例,鼻背部皱纹14例,双侧鱼尾纹44例.其结果 144例皱纹中显效114例占79.17%;满意23例占15.97%;失败7例占4.86%,总有效率为95.14%.无一例发生中毒、过敏、上睑下垂、复视、下睑外翻等严重并发症.证明了A型肉毒毒素注射治疗上半面部皱纹,安全快速、侵袭性小,临床效果优良.

  8. Analysis of a unique Clostridium botulinum strain from the Southern hemisphere producing a novel type E botulinum neurotoxin subtype

    Directory of Open Access Journals (Sweden)

    Raphael Brian H

    2012-10-01

    Full Text Available Abstract Background Clostridium botulinum strains that produce botulinum neurotoxin type E (BoNT/E are most commonly isolated from botulism cases, marine environments, and animals in regions of high latitude in the Northern hemisphere. A strain of C. botulinum type E (CDC66177 was isolated from soil in Chubut, Argentina. Previous studies showed that the amino acid sequences of BoNT/E produced by various strains differ by rarA operon. Results Genetic and mass spectral analysis demonstrated that the BoNT/E produced by CDC66177 is a novel toxin subtype (E9. Toxin gene sequencing indicated that BoNT/E9 differed by nearly 11% at the amino acid level compared to BoNT/E1. Mass spectrometric analysis of BoNT/E9 revealed that its endopeptidase substrate cleavage site was identical to other BoNT/E subtypes. Further analysis of this strain demonstrated that its 16S rRNA sequence clustered with other Group II C. botulinum (producing BoNT types B, E, and F strains. Genomic DNA isolated from strain CDC66177 hybridized with fewer probes using a Group II C. botulinum subtyping microarray compared to other type E strains examined. Whole genome shotgun sequencing of strain CDC66177 revealed that while the toxin gene cluster inserted into the rarA operon similar to other type E strains, its overall genome content shared greater similarity with a Group II C. botulinum type B strain (17B. Conclusions These results expand our understanding of the global distribution of C. botulinum type E strains and suggest that the type E toxin gene cluster may be able to insert into C. botulinum strains with a more diverse genetic background than previously recognized.

  9. Botulinum toxin type-A effect as a preemptive treatment in a model of acute trigeminal pain: a pre-clinical double-blind and placebo-controlled study

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    Elcio Juliato Piovesan

    2011-02-01

    Full Text Available The purpose of this study was to investigate if botulinum neurotoxin type-A (BoNT/A had a preemptive antinociceptive effect in a formalin-induced orofacial pain model (FT. To test this hypothesis, male Rattus norvegicus were injected with isotonic saline solution 0.9% or BoNT/A administered as a 40 μl bolus, lateral to their nose, at 24 hours, 8, 15, 22, 29 or 36 days pre-FT. The procedures were repeated 42 days later. Influence on motor activity was assessed through the open-field test. Pain scores corresponded to the time spent rubbing and flicking the injected area. Animals pre-treated with BoNT/A at the first protocol (8 days subgroup showed reduced inflammatory scores (p=0.011. For the other groups no significant results were observed at any phase. Motor activity was similar in both groups. BoNT/A showed to be effective preventing inflammatory pain up to eight days after the first treatment, an effect not reproduced on the second dose administration.

  10. Low pH-Induced Pore Formation by the T Domain of Botulinum Toxin Type A is Dependent upon NaCl Concentration

    Energy Technology Data Exchange (ETDEWEB)

    Lai, B.; Swaminathan, S.; Agarwal, R.; Nelson, L. D.; London, E.

    2010-07-19

    Botulinum neurotoxins (BoNTs) undergo low pH-triggered membrane insertion, resulting in the translocation of their light (catalytic) chains into the cytoplasm. The T (translocation) domain of the BoNT heavy chain is believed to carry out translocation. Here, the behavior of isolated T domain from BoNT type A has been characterized, both in solution and when associated with model membranes. When BoNT T domain prepared in the detergent dodecylmaltoside was diluted into aqueous solution, it exhibited a low pH-dependent conformational change below pH 6. At low pH the T domain associated with, and formed pores within, model membrane vesicles composed of 30 mol% dioleoylphosphatidylglycerol/70 mol% dioleoylphosphatidylcholine. Although T domain interacted with vesicles at low (50 mM) and high (400 mM) NaCl concentrations, the interaction required much less lipid at low salt. However, even at high lipid concentrations pore formation was much more pronounced at low NaCl concentrations than at high NaCl concentration. Increasing salt concentration after insertion in the presence of 50 mM NaCl did not decrease pore formation. A similar effect of NaCl concentration upon pore formation was observed in vesicles composed solely of dioleoylphosphatidylcholine, showing that the effect of NaCl did not solely involve modulation of electrostatic interactions between protein and anionic lipids. These results indicate that some feature of membrane-bound T domain tertiary structure critical for pore formation is highly dependent upon salt concentration.

  11. Biodiversity of Clostridium botulinum Type E Associated with a Large Outbreak of Botulism in Wildlife from Lake Erie and Lake Ontario ▿

    OpenAIRE

    Hannett, George E.; Stone, Ward B.; Davis, Stephen W.; Wroblewski, Danielle

    2010-01-01

    The genetic relatedness of Clostridium botulinum type E isolates associated with an outbreak of wildlife botulism was studied using random amplification of polymorphic DNA (RAPD). Specimens were collected from November 2000 to December 2008 during a large outbreak of botulism affecting birds and fish living in and around Lake Erie and Lake Ontario. In our present study, a total of 355 wildlife samples were tested for the presence of botulinum toxin and/or organisms. Type E botulinum toxin was...

  12. Uso de manometria computadorizada para estudo do espasmo do segmento faringoesofágico em pacientes com voz traqueoesofágica inadequada antes e após aplicação de toxina botulínica Computerized manometry use to evaluate spasm in pharyngoesophageal segment in patients with poor tracheoesophageal speech before and after treatment with botulinum toxin

    Directory of Open Access Journals (Sweden)

    Carlos T. Chone

    2009-04-01

    Full Text Available Voz traqueoesofágica (VTE com prótese fonatória (PF é método eficaz e reproduzível na reabilitação vocal após laringectomia total (LT, impedida pelo espasmo do segmento faringoesofágico (SFE. A manometria computadorizada (MC é novo método objetivo e direto de avaliação do SFE. OBJETIVO: Análise objetiva do espasmo do SFE, com MC, antes e após aplicação de toxina botulínica (TB. DESENHO DO ESTUDO: Prospectivo clínico. MATERIAL E MÉTODOS: Análise de oito pacientes consecutivos submetidos à LT com VTE e PF, sem emissão vocal, com espasmo do SFE à videofluoroscopia, considerado padrão ouro para detecção de espasmo. Todos trataram o espasmo com injeção de 100 unidades de TB no SFE. Avaliação constituiu-se de videofluoroscopia e MC do SFE, antes e após aplicação de TB. RESULTADOS: Houve diminuição na pressão do SFE à MC, após injeção de TB em todos. A média de pressão do SFE à MC, nos oito pacientes, antes da aplicação de TB foi de 25.36 mmHg e após foi de 14.31 mmHg (p=0,004. Houve emissão vocal sem esforço e melhora do espasmo do SFE à videofluoroscopia após o uso da TB. CONCLUSÃO: Foi observada diminuição na pressão do SFE após injeção da TB à MC em todos os pacientes, com melhora do espasmo à videofluoroscopia.Tracheoesophageal voice (TEV with voice prosthesis (VP is an efficient and reproducible method used in vocal rehabilitation after total laryngectomy (TL, prevented by spasms in the pharyngoesophageal segment (PES. Computerized Manometry (CM is a new, direct and objective method used to assess the PES. AIM: to carry out an objective analysis of the PES, with CM, before and after the injection of botulinum toxin (BT. STUDY DESIGN: clinical-prospective. MATERIALS AND METHODS: analysis of eight patients consecutively submitted to TL with TEV and VP, without vocal emission, with PES spasms seen through videofluoroscopy, considered the gold standard for spasm detection. All had their

  13. Botulinum Neurotoxin Serotypes Detected by Electrochemical Impedance Spectroscopy

    Science.gov (United States)

    Savage, Alison C.; Buckley, Nicholas; Halliwell, Jennifer; Gwenin, Christopher

    2015-01-01

    Botulinum neurotoxin is one of the deadliest biological toxins known to mankind and is able to cause the debilitating disease botulism. The rapid detection of the different serotypes of botulinum neurotoxin is essential for both diagnosis of botulism and identifying the presence of toxin in potential cases of terrorism and food contamination. The modes of action of botulinum neurotoxins are well-established in literature and differ for each serotype. The toxins are known to specifically cleave portions of the SNARE proteins SNAP-25 or VAMP; an interaction that can be monitored by electrochemical impedance spectroscopy. This study presents a SNAP-25 and a VAMP biosensors for detecting the activity of five botulinum neurotoxin serotypes (A–E) using electrochemical impedance spectroscopy. The biosensors are able to detect concentrations of toxins as low as 25 fg/mL, in a short time-frame compared with the current standard methods of detection. Both biosensors show greater specificity for their compatible serotypes compared with incompatible serotypes and denatured toxins. PMID:25954998

  14. Botulinum Neurotoxin Serotypes Detected by Electrochemical Impedance Spectroscopy

    Directory of Open Access Journals (Sweden)

    Alison C. Savage

    2015-05-01

    Full Text Available Botulinum neurotoxin is one of the deadliest biological toxins known to mankind and is able to cause the debilitating disease botulism. The rapid detection of the different serotypes of botulinum neurotoxin is essential for both diagnosis of botulism and identifying the presence of toxin in potential cases of terrorism and food contamination. The modes of action of botulinum neurotoxins are well-established in literature and differ for each serotype. The toxins are known to specifically cleave portions of the SNARE proteins SNAP-25 or VAMP; an interaction that can be monitored by electrochemical impedance spectroscopy. This study presents a SNAP-25 and a VAMP biosensors for detecting the activity of five botulinum neurotoxin serotypes (A–E using electrochemical impedance spectroscopy. The biosensors are able to detect concentrations of toxins as low as 25 fg/mL, in a short time-frame compared with the current standard methods of detection. Both biosensors show greater specificity for their compatible serotypes compared with incompatible serotypes and denatured toxins.

  15. Endoscopic botox injections in therapy of refractorygastroparesis

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Gastroparesis (GP) is a common disease seen in gastroenterologypractice particularly in western countries,and it may be underdiagnosed. The available drugtherapies for this condition are quite disappointing.Botulinum toxin type A (BT) has been found to be effectivetherapy in various spastic disorders of smoothmuscle of gastrointestinal tract. However, the benefitsof BT injections in GP have been unclear. Severalretrospective and open label studies have shown clinicaladvantages of intrapyloric Botulinum toxin type Ainjections, while two small randomized trials did notshow positive results. Therefore, the available publishedstudies yielded conflicting results leading to fading outof botox therapy for GP. We recognize possible clinicalbenefit of BT injections without any disadvantages of thistreatment.We are calling for revisiting the endoscopyguided botox therapy in refractory GP. In this reviewwe discuss important features of these studies pointingout differences in results among them. Differences inpatient selection, doses and method of administrationof botox toxin in the prior studies may be the cause ofconflicting results. The mechanism of action, indications,efficacy and side-effects of BT are reviewed. Finally, werecognize limited evidence to recommend BT in GP andcalling attention for future research in this field since noadvances in drug management had been made in thelast two decades.

  16. Anti-inflammatory effects of botulinum toxin type A in a rat model of arthritis%A型肉毒毒素关节腔注射对佐剂性关节炎大鼠的抗炎效果观察

    Institute of Scientific and Technical Information of China (English)

    王开乐; 初晓; 张仲义; 王琳; 沈娜娜; 薛俊强; 李铁山

    2016-01-01

    Objective To verify the anti-inflammatory effects of intra-articular injection of botulinum toxin type A (BoNT/A) on adjuvant-induced arthritis using a rat model.Methods A murine model of chronic ankle arthritis was established in 90 Wistar rats by injection of 0.1 ml of complete Freund adjuvant (CFA) into the pads of their left paws.They were then randomly divided into a BoNT group (n =30) which received an intra-articular injection of 0.1 ml (20 IU) of BoNT/A,an NS group (n=30) which received intra-articular injection of0.1 ml of normal saline solution and a sham group (n =30) which were punctured without any injection.In addition,30 normal rats formed a control group.Infrared thermal imaging was performed and an index of arthritis was evaluated every three days.The infrared thermal imaging revealed the expression of interleukin-1β (IL-1β) through hematoxy-eosin (HE) staining.Results The arthritis index began to increase 3 days after the injection of CFA and it had increased significantly after 10 days,reaching a peak value of 18,24 days after the injection.The infrared thermal imaging showed that the temperature in the right paw increased greatly after the injection.Following the development of arthritis,the temperature declined gradually,arriving at a steady temperature of between 37.5 and 38.0 ℃ in both ankles 20 days after the injection.The average temperature in both paws of the BoNT group had decreased significantly more by 7 and 14 days after the injection than in the NS and sham groups.The expression of IL-1β in the synovium of the ankle joint also had decreased significantly more in the BoNT group after 7 and 14 days.HE scoring showed an obvious histopathologic change in the hypertrophic synovium,inflamnatory cell infiltration,cartilage destruction and exposure of subchondral bone after 7 and 14 days compared with right after the injection in all groups except the control group.Moreover,the average HE scores of the BoNT group rats after 7 and 14

  17. Botulinum toxin type A for the treatment of palmar hyperhidrosis: a prospective study of 26 patients%A型肉毒毒素注射治疗26例手多汗症的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨红军; 彭凯润; 邓兵梅; 程飚

    2012-01-01

    手多汗症是指发生于手掌的过多的出汗,给造成社交和就业上的困难.本研究对A型肉毒毒素治疗手多汗症的疗效进行临床观察.选择26例手多汗症患者(女17例,男9例),参照多汗症量表评估其出汗严重程度.记录患者A型肉毒毒素注射前后出汗评分、起效时间、副作用等指标.结果发现A型肉毒毒素注射后手出汗明显减少,效果持续3个月以上,而且副作用轻微且一过性.A型肉毒毒素注射治疗手多汗症是安全、有效的实用方法.%Palmar hyperhidrosis is characterized by excessive sweating in hand,it has a significant impact on the social and professional relationships of affected individuals.The aim of this study was to assess effect of botulinum toxin type A (BTX-A) to patients with palmar hyperhidrosis.The study included 26 patients (17 women and 9 men) with a diagnosis of Palmar hyperhidrosis treated with BTX-A. severity of hyperhidrosis qualitative measured by The Hyperhidrosis Disease Severity Scale (HDSS). All patients completed a questionnaire included the following information: time to effect of BTX-A; local or systemic side effects; and severity of hyperhidrosis before and after BTX-A treatment.There was a highly significant reduction in the severity of hyperhidrosis 3 months after performing the treatment with BTX-A. The side effects of treatment were sligtht and short. Treatment of Palmar hyperhidrosis with BTX-A was well tolerated and effective.

  18. Consequences of neurologic lesions assessed by Barthel Index after Botox® injection may be underestimated

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    Dionyssiotis Y

    2012-10-01

    Full Text Available Y Dionyssiotis,1,2 D Kiourtidis,3 A Karvouni,3 A Kaliontzoglou,3 I Kliafas31Medical Department, Rehabilitation Center Amyntaio, General Hospital of Florina, Amyntaio, Florina, 2Physical Medicine and Rehabilitation Department, Rhodes General Hospital, Rhodes, Dodecanese, 3Neurologic Department, Rhodes General Hospital, Rhodes, Dodecanese, GreecePurpose: The aim of this study was to investigate whether the consequences of neurologic lesions are underestimated when the Barthel Index (BI is used to assess the clinical outcome of botulinum toxin injection.Patients and methods: The records for all in- and outpatients with various neurologic lesions (stroke, multiple sclerosis, spinal cord injury, traumatic brain injury, and so forth who had been referred to the authors’ departments and who had received botulinum toxin type A (Botox® for spasticity within a 4-year period (2008–2011 were examined retrospectively. BI data were collected and analyzed.Results: The BI score was found to have increased in follow-up assessments (P = 0.048. No correlation was found between the degree of spasticity and the BI score.Conclusion: The specific injection of Botox in patients with neurologic lesions was not strongly correlated with a significant functional outcome according to the BI. The results of this study suggest that clinicians need to look at other measurement scales for the assessment of significant outcomes of Botox in the rehabilitation process after neurologic lesions.Keywords: botulinum toxin type A, spasticity, stroke, multiple sclerosis

  19. A new mouse model for renal lesions produced by intravenous injection of diphtheria toxin A-chain expression plasmid

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    Nakamura Shingo

    2004-04-01

    Full Text Available Abstract Background Various animal models of renal failure have been produced and used to investigate mechanisms underlying renal disease and develop therapeutic drugs. Most methods available to produce such models appear to involve subtotal nephrectomy or intravenous administration of antibodies raised against basement membrane of glomeruli. In this study, we developed a novel method to produce mouse models of renal failure by intravenous injection of a plasmid carrying a toxic gene such as diphtheria toxin A-chain (DT-A gene. DT-A is known to kill cells by inhibiting protein synthesis. Methods An expression plasmid carrying the cytomegalovirus enhancer/chicken β-actin promoter linked to a DT-A gene was mixed with lipid (FuGENE™6 and the resulting complexes were intravenously injected into adult male B6C3F1 mice every day for up to 6 days. After final injection, the kidneys of these mice were sampled on day 4 and weeks 3 and 5. Results H-E staining of the kidney specimens sampled on day 4 revealed remarkable alterations in glomerular compartments, as exemplified by mesangial cell proliferation and formation of extensive deposits in glomerular basement membrane. At weeks 3 and 5, gradual recovery of these tissues was observed. These mice exhibited proteinuria and disease resembling sub-acute glomerulonephritis. Conclusions Repeated intravenous injections of DT-A expression plasmid DNA/lipid complex caused temporary abnormalities mainly in glomeruli of mouse kidney. The disease in these mice resembles sub-acute glomerulonephritis. These DT-A gene-incorporated mice will be useful as animal models in the fields of nephrology and regenerative medicine.

  20. Re-Assembled Botulinum Neurotoxin Inhibits CNS Functions without Systemic Toxicity

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    Bazbek Davletov

    2011-03-01

    Full Text Available The therapeutic potential of botulinum neurotoxin type A (BoNT/A has recently been widely recognized. BoNT/A acts to silence synaptic transmission via specific proteolytic cleavage of an essential neuronal protein, SNAP25. The advantages of BoNT/A-mediated synaptic silencing include very long duration, high potency and localized action. However, there is a fear of possible side-effects of BoNT/A due to its diffusible nature which may lead to neuromuscular blockade away from the injection site. We recently developed a “protein-stapling” technology which allows re-assembly of BoNT/A from two separate fragments. This technology allowed, for the first time, safe production of this popular neuronal silencing agent. Here we evaluated the re-assembled toxin in several CNS assays and assessed its systemic effects in an animal model. Our results show that the re-assembled toxin is potent in inhibiting CNS function at 1 nM concentration but surprisingly does not exhibit systemic toxicity after intraperitoneal injection even at 200 ng/kg dose. This shows that the re-assembled toxin represents a uniquely safe tool for neuroscience research and future medical applications.

  1. Tratamiento de la cefalea tensional con toxina botulínica tipo A Botulinum toxin type A for the treatment of tension-type headache

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    D. Arbaiza

    2006-06-01

    el área total de aplicación, como probables factores en la respuesta analgésica.Objectives: To determine the time of onset of the analgesia, the < ficacy and the security of the application of the botulinu toxin A (BTA in patient with tension-type headache (TH. Material and methods: Inclusion criteria: patients between 18 and 70 yeai diagnosis of TH according to the International Headache S ciety, two or more episodes of TH per month during at lea 3 months, non controlled TH with the standard treatmei normal neurological examination and signed inform consei Variables analyzed: Intensity of headache (IH, frequency presentation of headache (FH, duration of headache (DH sensibility to digit pressure (SDP of the cranial musculatur number of painful points (NPD of the cranial musculatur time of onset of the analgesia (TBA, time until the ma: mum effect of analgesia (TMA and decrease of use of an.gesics (DUA. Evaluations in the days 0, 15 and 30. Fifty units of BT were applied to cranial musculature. The patients could continue with their previous analgesic therapy according to the evolution of the headache. Results: Twenty female patients were included with a median age of 47 years. IH 2.15 in the first evaluation diminished at 1.05 and 0.9 in the second and third evaluations (p=0.009 and 0.008. FH of 10.25 days diminished to 3.6 and 2.75 days (p=0.008 and 0.012. DH of 2.3 daily hours it diminished at 1.3 and 1.1 (p=0.009 in both. SDP 1.55 diminished at 0.5 and 0.55 (p=0.008 in both. NPD 2.65 diminished at 0.8 and 0.6 (p=0.010 and 0.006. TBA was 8 days and TMA was 25 days. DUA 5 diminished at 1.9 and 1.5. Around of 35% of the patients presented a probable adverse event of mild or moderate severity. Conclusion: TB-TO it is a simple, effective treatment and provides control of the TH. The technique is easy to reproduce. More studies are needed to value the number of applications and the total area of application, as probable factors in the analgesic response.

  2. Toxina botulínica tipo A para el manejo del dolor en pacientes con síndrome de dolor miofascial crónico Botulinum toxin type A for the management of pain in patients with chronic myofascial pain

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    J.C. Torres Huerta

    2010-02-01

    Full Text Available Introducción: El síndrome de dolor miofascial es uno de los principales problemas de dolor crónico en la práctica clínica, comúnmente asociado a un traumatismo o a microtraumatismos repetitivos. La toxina botulínica tipo A (Botox® es una alternativa aceptada como opción terapéutica. Objetivo: Valorar la funcionalidad de las actividades diarias mejorando la intensidad del dolor con el uso de la toxina botulínica tipo A, infiltrada en puntos gatillo, en pacientes con síndrome de dolor miofascial crónico. Material y métodos: 30 pacientes con síndrome de dolor miofascial crónico con edad entre 25 y 50 años de ambos sexos. A todos se les realizó infiltración de puntos gatillo mediante equipo de electrosonomiografía para la aplicación de toxina botulínica tipo A a una dilución de las 100 Um de toxina en 1 ml de solución salina infiltrando de 200 a 400 Um totales, dependiendo del sitio del dolor. Se valoró la calidad analgésica mediante la escala visual analógica (EVA y el índice de funcionalidad con el cuestionario de Oswestry durante 4 semanas. Resultados: La valoración de la EVA promedio inicial fue de 7,23 y la final de 3,13 (p Introduction: Myofascial syndrome is one of the main chronic pain syndromes encountered in clinical practice and is commonly associated with trauma or repetitive microtrauma. Botulinum toxin type A (Botox® is an accepted therapeutic option. Objective: To evaluate the use of botulinum toxin type A (Botox®, infiltrated in trigger points, as an option in the management of pain in patients with chronic myofascial syndrome. Material and Methods: Thirty men and women with myofascial pain syndrome, aged between 25 and 50 years were included. In all patients, botulinum toxin type A (Botox® was infiltrated in trigger points by means of electrosonomyographic equipment. A dilution of 100 Um toxin in 1 cc saline solution was used and a total of 200 to 400 Um was administered depending on the site of the

  3. Characterization of botulinum neurotoxin type A neutralizing monoclonal antibodies and influence of their half-lives on therapeutic activity.

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    Christelle Mazuet

    Full Text Available Botulinum toxins, i.e. BoNT/A to/G, include the most toxic substances known. Since botulism is a potentially fatal neuroparalytic disease with possible use as a biowarfare weapon (Centers for Disease Control and Prevention category A bioterrorism agent, intensive efforts are being made to develop vaccines or neutralizing antibodies. The use of active fragments from non-human immunoglobulins (F(ab'(2, Fab', scFv, chemically modified or not, may avoid side effects, but also largely modify the in vivo half-life and effectiveness of these reagents. We evaluated the neutralizing activity of several monoclonal anti-BoNT/A antibodies (mAbs. F(ab'(2 fragments, native or treated with polyethyleneglycol (PEG, were prepared from selected mAbs to determine their half-life and neutralizing activity as compared with the initial mAbs. We compared the protective efficiency of the different biochemical forms of anti-toxin mAbs providing the same neutralizing activity. Among fourteen tested mAbs, twelve exhibited neutralizing activity. Fragments from two of the best mAbs (TA12 and TA17, recognizing different epitopes, were produced. These two mAbs neutralized the A1 subtype of the toxin more efficiently than the A2 or A3 subtypes. Since mAb TA12 and its fragments both exhibited the greatest neutralizing activity, they were further evaluated in the therapeutic experiments. These showed that, in a mouse model, a 2- to 4-h interval between toxin and antitoxin injection allows the treatment to remain effective, but also suggested an absence of correlation between the half-life of the antitoxins and the length of time before treatment after botulinum toxin A contamination. These experiments demonstrate that PEG treatment has a strong impact on the half-life of the fragments, without affecting the effectiveness of neutralization, which was maintained after preparation of the fragments. These reagents may be useful for rapid treatment after botulinum toxin A

  4. Neutralization of Botulinum Neurotoxin Type E by a Humanized Antibody

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    Derman, Yağmur; Selby, Katja; Miethe, Sebastian; Frenzel, André; Liu, Yvonne; Rasetti-Escargueil, Christine; Avril, Arnaud; Pelat, Thibaut; Urbain, Remi; Fontayne, Alexandre; Thullier, Philippe; Sesardic, Dorothea; Lindström, Miia; Hust, Michael; Korkeala, Hannu

    2016-01-01

    Botulinum neurotoxins (BoNTs) cause botulism and are the deadliest naturally-occurring substances known to humans. BoNTs have been classified as one of the category A agents by the Centers for Disease Control and Prevention, indicating their potential use as bioweapons. To counter bio-threat and naturally-occurring botulism cases, well-tolerated antibodies by humans that neutralize BoNTs are relevant. In our previous work, we showed the neutralizing potential of macaque (Macaca fascicularis)-derived scFv-Fc (scFv-Fc ELC18) by in vitro endopeptidase immunoassay and ex vivo mouse phrenic nerve-hemidiaphragm assay by targeting the light chain of the botulinum neurotoxin type E (BoNT/E). In the present study, we germline-humanized scFv-Fc ELC18 into a full IgG hu8ELC18 to increase its immunotolerance by humans. We demonstrated the protection and prophylaxis capacity of hu8ELC18 against BoNT/E in a mouse model. A concentration of 2.5 ng/mouse of hu8ELC18 protected against 5 mouse lethal dose (MLD) in a mouse protection assay and complete neutralization of 1 LD50 of pure BoNT/E toxin was achieved with 8 ng of hu8ELC18 in mouse paralysis assay. Furthermore, hu8ELC18 protected mice from 5 MLD if injected up to 14 days prior to intraperitoneal BoNT/E administration. This newly-developed humanized IgG is expected to have high tolerance in humans. PMID:27626446

  5. Neutralization of Botulinum Neurotoxin Type E by a Humanized Antibody

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    Yağmur Derman

    2016-09-01

    Full Text Available Botulinum neurotoxins (BoNTs cause botulism and are the deadliest naturally-occurring substances known to humans. BoNTs have been classified as one of the category A agents by the Centers for Disease Control and Prevention, indicating their potential use as bioweapons. To counter bio-threat and naturally-occurring botulism cases, well-tolerated antibodies by humans that neutralize BoNTs are relevant. In our previous work, we showed the neutralizing potential of macaque (Macaca fascicularis-derived scFv-Fc (scFv-Fc ELC18 by in vitro endopeptidase immunoassay and ex vivo mouse phrenic nerve-hemidiaphragm assay by targeting the light chain of the botulinum neurotoxin type E (BoNT/E. In the present study, we germline-humanized scFv-Fc ELC18 into a full IgG hu8ELC18 to increase its immunotolerance by humans. We demonstrated the protection and prophylaxis capacity of hu8ELC18 against BoNT/E in a mouse model. A concentration of 2.5 ng/mouse of hu8ELC18 protected against 5 mouse lethal dose (MLD in a mouse protection assay and complete neutralization of 1 LD50 of pure BoNT/E toxin was achieved with 8 ng of hu8ELC18 in mouse paralysis assay. Furthermore, hu8ELC18 protected mice from 5 MLD if injected up to 14 days prior to intraperitoneal BoNT/E administration. This newly-developed humanized IgG is expected to have high tolerance in humans.

  6. Effect of botulinum toxin type A on the expression of substance P, calcitionin gene-related peptide,transforming growth factor beta-1 and alpha smooth muscle actin A in wound healing in rats%肉毒毒素A对大鼠皮肤及创面组织中SP、CGRP、TGF-β1和α-SMA的影响

    Institute of Scientific and Technical Information of China (English)

    王琳; 邰宁正; 范志宏

    2009-01-01

    Objective To investigate the effect of botulinum toxin type A on the expression of substance P(SP),calcitionin gene-related peptide(CGRP), transforming growth factor beta-1 (TGF-β1) and alpha smooth muscle actin A(α-SMA) in wound healing. Methods 60 rats were randomly divided into group C (control)、 group L (low-dose) and group H (high-dose), with 20 rats in each group. The wound-healing model was established by excision of four full-thickness skin(1 cm×1 cm, around the injection site) on the back of all SD rats on the 7th day after BTA injection. The wound size was measured and the expression of SP, CGRP, TGF-β1 and α-SMA in wound granulation tissue was assayed by immanohistocbemical staining and computerized image analysis before operation, and 3 days, 7 days and 14 days after operation. Results All the wounds healed 14 days after operation. The wound size in L and H group was not significantly different with that in C group on the 3rd day and 7th day after operation. The positive immuno-staining of SP, CGRP, TGF-β1 and α-SMA in group L and H was significantly weaker than those in C group. Meanwhile, the positive immuno-staining of all above substances in H group was weaker than those in L group significantly. Conclusions Botulinum toxin type A can decrease the expression of SP, CGRP, TGF-β1 and α-SMA in wound healing in a dose-dependent manner with no effect on the healing time.%目的 探讨肉毒毒素A对周围神经末梢释放的感觉神经肽P物质、降钙素基因相关肽及创面组织表达TGF-β1和α-平滑肌肌动蛋白的影响. 方法 60只SD大鼠随机分为空白对照组(C组)、低剂量组(L组)和高剂量组(H组),每组加只大鼠.肉毒毒素A预注射后7 d,在鼠背部建立以4个注射点为中心的创面模型,创面面积1 cm×1 cm.于术前及术后3、7、14 d,测量创面面积,免疫组织化学和Axioplan 2 Imaging图像分析软件检测多聚甲醛灌注后创面P物质、降钙素基因相关肽以及创

  7. Effect of botulinum toxin A on tibial nerve F wave and walking ability in patients after stroke%A型肉毒毒素对脑卒中患者胫神经F波和步行能力的影响

    Institute of Scientific and Technical Information of China (English)

    王明乐; 刘俊芳; 马妮娜

    2015-01-01

    将脑卒中患者65例随机分为观察组32例和对照组33例,观察组患者则在开始常规康复训练治疗前,接受患侧下肢肌肉A型肉毒毒素局部注射治疗.观察两组患者治疗前及治疗4周后的F波波幅及M波比值(F/M值),肌张力及起立-行走计时测试(TUG)及10 m自由步行测试结果.观察组治疗2周及4周后,F波波幅及F/M值与治疗前比较均显著下降(P<0.05);治疗后各时间点指标与对照组比较,差异有统计学意义(P<0.05).对照组治疗前后肌张力评分比较,差异无统计学意义(P>0.05);观察组治疗4周后,肌张力评分显著下降(P<0.05),与对照组比较差异有统计学意义(P<0.05).治疗前,两组患者的TUG测试及10 m自由步行测试比较差异无统计学意义(P>0.05);观察组治疗4周后,TUG测试及10 m自由步行测试与治疗前比较差异有统计学意义(P<0.05);而对照组治疗前后TUG测试及10 m自由步行测试比较差异无统计学意义(P>0.05).提示,A型肉毒毒素局部注射可降低相应脊髓节段运动神经元的F波波幅,提高患者的步行能力.%Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P < 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P < 0.05).The muscle tension score in study group after 4 weeks of treatment decreased

  8. Biodiversity of Clostridium botulinum type E associated with a large outbreak of botulism in wildlife from Lake Erie and Lake Ontario.

    Science.gov (United States)

    Hannett, George E; Stone, Ward B; Davis, Stephen W; Wroblewski, Danielle

    2011-02-01

    The genetic relatedness of Clostridium botulinum type E isolates associated with an outbreak of wildlife botulism was studied using random amplification of polymorphic DNA (RAPD). Specimens were collected from November 2000 to December 2008 during a large outbreak of botulism affecting birds and fish living in and around Lake Erie and Lake Ontario. In our present study, a total of 355 wildlife samples were tested for the presence of botulinum toxin and/or organisms. Type E botulinum toxin was detected in 110 samples from birds, 12 samples from fish, and 2 samples from mammals. Sediment samples from Lake Erie were also examined for the presence of C. botulinum. Fifteen of 17 sediment samples were positive for the presence of C. botulinum type E. Eighty-one C. botulinum isolates were obtained from plants, animals, and sediments; of these isolates, 44 C. botulinum isolates produced type E toxin, as determined by mouse bioassay, while the remaining 37 isolates were not toxic for mice. All toxin-producing isolates were typed by RAPD; that analysis showed 12 different RAPD types and multiple subtypes. Our study thus demonstrates that multiple genetically distinct strains of C. botulinum were involved in the present outbreak of wildlife botulism. We found that C. botulinum type E is present in the sediments of Lake Erie and that a large range of bird and fish species is affected. PMID:21115703

  9. Botulinum-A toxin in the treatment of painful post-stroke nocturnal paroxysmal dystonia triggered by periodic limb movements of sleep: case report Toxina botulínica tipo A no tratamento da distonia paroxística noturna dolorosa pós-isquemia cerebral desencadeada por movimentos periódicos do sono: relato de caso

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    Pedro A. Kowacs

    2006-12-01

    Full Text Available INTRODUCTION: Sleep disorders presenting involuntary movements may be very annoying to patients, apart from their negative influence on sleep. OBJECTIVE: To report the use of botulinum type-A toxin (BoNT-A to manage the case of a patient whose sleep was severely disrupted by episodes of dystonic posturing of the right lower limb triggered by periodic limb movements of sleep (PLMS. METHOD: A 79-year-old woman with mild post-stroke right hemiparesis presented with recurrent painful episodes of dystonia of the right lower limb, which disrupted her sleep. The dystonic episodes could also be voluntarily triggered by extension of the right hallux. Polysomnography confirmed that the dystonic episodes were triggered by PLMS. Twenty units of BoNT-A (20U/500U vial were injected into her right extensor hallucis longus. RESULTS: Shortly after BoNT-A was injected, the dystonic symptoms abated, and the patient achieved better sleep efficiency. CONCLUSION: The PLMS-related involuntary extension of the hallux was probably triggering the nocturnal post-stroke lower limb dystonic paroxysms. BoNT-A injection into the right extensor hallucis longus was effective in managing this condition and thus resolved the associated disruption of sleep.INTRODUÇÃO: Desordens do sono apresentando movimentos involuntários podem ser bastante perturbadoras aos pacientes, além de sua influência negativa no sono. OBJETIVO: Descrever o uso da toxina botulínica tipo-A (BoNT-A no manejo do caso de um paciente cujo sono estava gravemente fragmentado por episódios de distonia do membro inferior direito, desencadeados por movimentos periódicos do sono (MPS. MÉTODO: Uma paciente com 79 anos portadora de hemiparesia direita leve seqüelar a isquemia cerebral (AVCI procurou-nos por episódios dolorosos recorrentes de distonia noturna de seu membro inferior direito, os quais fragmentavam seu sono. Os episódios de distonia também podiam ser desencadeados voluntariamente, por extens

  10. Learning from the past: historical aspects of bacterial toxins as pharmaceuticals.

    Science.gov (United States)

    Pellett, Sabine

    2012-06-01

    Botulinum neurotoxins are the most poisonous substances known to humankind, but also are the bacterial toxins most frequently used as pharmaceuticals to benefit humans. The discovery of botulinum toxins and development into a useful drug is unique and fascinating, dating back to the early 19th century, when Justinus Kerner first recognized that botulism was caused by a biological toxin and suggested its use for medicinal purposes. This was translated into reality in 1980, when Alan Scott for the first time used the toxins to successfully treat strabismus. Now a subset of botulinum toxins are widely used for cosmetic applications, treatment of various movement disorders, pain and many other syndromes, and further developments using other botulinum toxins or recombinant molecules engineered from subdomains are promising.

  11. Botulinum Neurotoxin A for Parotid Enlargement in Cystic Fibrosis: The First Case Report.

    Science.gov (United States)

    El Khoury, Joseph; Habre, Samer; Nasr, Marwan; Hokayem, Nabil

    2016-09-01

    Cystic fibrosis (CF) is the most common lethal autosomal recessive genetic disease associated with exocrine gland dysfunction. Salivary gland involvement is a common finding. The literature on submaxillary gland involvement has failed to address the parotid gland and any specific treatment of salivary gland manifestations of CF. Treatment is mainly symptomatic, consisting of analgesics, gustatory stimulation, and massage. Salivary secretion has clearly been linked to parasympathetic and sympathetic signals through intracellular calcium release. CF alters salivary composition with increased calcium and phosphorus concentrations and causes histologic changes (duct enlargement, dilation of acini, and abnormal mucous plugs). This study investigated whether botulinum toxin injected into the parotid gland during an acute exacerbation of CF-associated salivary gland disease could alleviate pain and control future exacerbations.

  12. Universal and specific quantitative detection of botulinum neurotoxin genes

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    Arnon Stephen S

    2010-10-01

    Full Text Available Abstract Background Clostridium botulinum, an obligate anaerobic spore-forming bacterium, produces seven antigenic variants of botulinum toxin that are distinguished serologically and termed "serotypes". Botulinum toxin blocks the release of acetylcholine at neuromuscular junctions resulting in flaccid paralysis. The potential lethality of the