BOTULINUM TOXIN IN NEUROLOGICAL DISORDERS
Botulinum neurotoxins ( collected from bacteria Clostridium Botulinum) over a period of time have been transformed from potential weapon in biological warfare to therapeutic solution for a host of medical conditions. The use of Botulinum toxin ( commercial name Botox) for treatment of wrinkles on face as anti ageing solution has made it quite popular, But not many know about its other uses especially in Neurological Disorders characterised by muscle overactivity.
Source
The anaerobic bacteria Clostridium botulinum secretes seven known serotypes of botulinum toxin, typed alphabetically A-G. Only types A and B have been utilized for commercial applications.
How It works?
Acetylcholine is the chemical secreted by nerves at their junction with muscles. This acetylcholine helps in contraction of muscles. Botulinum toxin impairs the release of acetylcholine at neuromuscular junction, thus allowing the muscles to relax particularly in disorders with muscle overactivity.
Neurological Disorders where Botulinum toxin can be used :
1. Blepharospasm ( Involuntary forceful closure of eyes)
2. Hemifacial spasm ( Abnormal twitching of facial muscles )
3. Dystonia (Abnormal posturing of Neck or limbs)
4. Writing Dystonia/Tremors
5. Limb spasticity ( Stiffness of arm and legs)
6. Hyperhidrosis (Excessive sweating of palms)
7. Hypersalivation ( Excessive saliva in mouth)
8. Refractory Migraine ( Not relieved with medications)
9. Trismus ( Jaw lock )
10. Tic disorder and Bruxism
These are the conditions which cause patient to avoid social gatherings/situations. Medications are not much effective in these disorders while Botulinum toxin can provide significant relief, enhancing the quality of life.
Administration
Administration of Botulinum toxin injections in the affected muscles or area is done on the out patient basis and usually does not require hospitalization. The dose of Botulinum toxin is decided on the basis of area involved and severity of disease.
Myths and facts
1. Myth-It is a toxin and it might affect the overall health,
Fact- The dose and dilution at which commercial preparations come usually does not cause systemic side effects.
2. Myth – It can cause permanent weakness of muscles.
Fact – It decreases the activity of overactive muscles that too temporarily and has to be repeated after 4-6 months.
3. Myth – It is very expensive
Fact- If you consider the cost of medicines and loss of productivity of patient, It becomes cost effective.
Botulinum toxin is very useful remedy for physically and socially disabling neurological disorders where medications are not of much use. It can enhance the quality of life of these patients along with their productivity without much of side effects and burden of taking medicines.