TREATMENT OF PATHOLOGICAL MUSCULAR OVERCO NTRACTIONS WITH LOCAL INJECTIONS OF BOTULINUM TOXIN TYPE-A

The idea of the potential therapeutic use of botulinum toxin was first developed by Justinus Kerner (1786-1862); a German physician and poet , who systematically studied botulism and published his idea in 1822. Since the first report of successfull therapeutic application in human s in 1981, botulinum toxin meanwhile has gained an important role in t he symptomatic treatment of conditions with pathological muscular over contractions. Botulinum toxin weakens the injected muscles by blocking the release of acetylcholine at the neuromuscular junction. The clini cal effect lasts between 10 and 16 weeks. in Germany, botulinum toxin is licensed for the treatment of blepharospasm, hemifacial spasm and r otatory spasmodic torticollis. The injections should be performed in e xperienced institutions only. There are other well documented indicati ons, such as writers cramp and spasmodic dysphonia. Botulinum toxin ha s shown also promising results in the treatment of spasticity. In gast rointestinal disorders, e.g. achalasia, the toxin injections have show n beneficial effects. This overview informs about the current developm ents in botulinum toxin therapy.