Daily Bolus of LR: Botulinum Toxin

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March 6, 2012 by dailybolusoflr

Botulinum Toxin
Botulinum toxin is being used in medicine for more than just botox injections!
Botulinum toxin inhibits release of acetylcholine at the neuromuscular junction and in cholinergic sympathetic and parasympathetic neurons
Local injections of toxin weaken overactive muscles-hence why it is used in treatment for dystonias, such as torticollis or hemifacial spasm.  It is also used as an adjunctive treatment in spasticity and tardive dyskinesia.
Local injection can also help to control hypersecretion of glands supplied by cholinergic neurons and thus explain its  use in hyperhidrosis
Local injections have also been shown to be beneficial in other conditions such as achalasia and chronic anal fissures
The main side effect of concern is weakness in adjacent muscles. Given its frequent use in torticollis, patients who receive injections into the neck muscles may develop dysphagia because of diffusion of the toxin into the oropharynx.  With the duration of action lasting around 3 months, those patients who are severely affected may require assisted
nutritional delivery, such as PEG tube placement while the effects of the toxin wear off.

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