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CNS Drugs
Published in: CNS Drugs 9/2008

01-09-2008 | Review Article

Use of Botulinum Toxin A in Adult Neurological Disorders

Efficacy, Tolerability and Safety

Author: Dr Wilhelm J. Schulte-Mattler

Published in: CNS Drugs | Issue 9/2008

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Abstract

The protein botulinum neurotoxin A (BoNT/A) is one of seven distinct neurotoxins produced by Clostridium botulinum. BoNT/A blocks cholinergic synapses with an extremely high specificity and potency. Appropriately purified and diluted, BoNT/A serves as a reliable and well tolerated drug that is applied by local injection.
The efficacy of BoNT/A is evident in the symptomatic therapy of disorders in which muscular hyperactivity plays a prominent role, such as focal dystonias and hemifacial spasm; in these disorders, BoNT/A is considered first-line therapy. BoNT/A is also beneficial in the treatment of both adults and children with spasticity of various causes. The pain that frequently accompanies these conditions is effectively reduced by BoNT/A. A genuine analgesic effect for BoNT/A unrelated to skeletal muscle spasmolysis has been suggested on the basis of in vitro and in vivo (animal) data. However, studies in humans designed to detect such an effect were negative, as were controlled studies of BoNT/A in patients with primary headache disorders.
BoNT/A also acts on cholinergic synapses of the autonomic nervous system, and injection of BoNT/A into salivary glands significantly decreases the production of saliva. This may be beneficial for patients with Parkinson’s disease, in whom the excessive production of saliva may be problematic.
Overall, BoNT/A has been confirmed as an efficacious, predictable and well tolerated drug in an ever-increasing number of neurological disorders.
Footnotes
1
The use of trade names is for product identification purposes only and does not imply endorsement.
 
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Metadata
Title
Use of Botulinum Toxin A in Adult Neurological Disorders
Efficacy, Tolerability and Safety
Author
Dr Wilhelm J. Schulte-Mattler
Publication date
01-09-2008
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 9/2008
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/00023210-200822090-00002

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