THERAPEUTIC USE OF BOTULINUM-A TOXIN IN N EUROLOGICAL DISORDERS

The highly potent neurotoxins produced by Clostridium botulinum lead t o botulism when ingested in appreciable amounts. However, botulinum to xin injections delivered intramuscularly in very small quantities can produce a therapeutically intended focal paresis while producing only negligible local or systemic side effects. Over the past several years , various neurological disorders, especially those involving increased muscle tone and/or abnormal movements, have been successfully treated with local botulinum A toxin injections. The success of this method h as led to a general change in the management of blepharospasm, tortico llis spasmodicus, hemifacial spasm, and other disorders. Treatment is usually effective for 4 to 12 weeks; if symptoms recur, the injections can be repeated over a period of several years, usually with the same success. Side effects depend on the site of the injections, and are r are at the optimal dosage and always reversible. For optimum therapeut ic results, this treatment must be restricted to specialized centers.