What is botulinum toxin?
Botulinum toxin is a protein. It can stop some of the chemical messages that
are sent from nerves. These messages tell the muscles to contract in spasms
(to tighten up). Botulinum toxin is used to stop muscle spasms because it blocks
these messages.
Are botulinum toxin injections safe?
Botulinum toxin is made by the same bacterium that causes food poisoning. A
high dose of botulinum toxin could be fatal, just as food poisoning can be
fatal. However, the dose given in injections is so small that it's unlikely
you'll have any harmful effects from the toxin.
Botulinum toxin has been used safely in thousands of people. It has been used
for more than 10 years.
Why do I need botulinum toxin injections?
Your doctor may be considering botulinum toxin injections to treat certain
muscle spasms on your face or eyelids. The injections can also be used for
some eye movement disorders, such as a lazy eye. Botulinum toxin is a standard
treatment for spasmodic torticollis, a muscle spasm that causes the head
and neck to pull in one direction. Your doctor may use the botulinum toxin
injections to treat other problems as well. Botulinum toxin has proven
to be useful in the treatment of many forms of dystonia, including the
following:
- blepharospasm — forceful involuntary closure of the eyelids
- strabismus — misalignment
of the eyes
- hemifacial spasm — sudden contraction of the muscles on
one side of the face
- spasmodic torticollis, or cervical dystonia — muscle
spasm in the neck that
causes the head to turn to one side, and sometimes forward or backward
- oromandibular
dystonia — continuous spasms of the face, jaw, neck,
tongue,
larynx, and in severe cases, the respiratory system
- urinary retention — severe
inability to urinate that requires catheterization
- spasmodic dysphonica — spasm
of the vocal cords that causes sudden disruption
of speech
- stuttering — repetitions of parts of words and whole words,
long pauses, elongated sounds
- voice tremor — quavering vocalization
Neurons generate new nerve endings
that reactivate the dystonia, so improvement is not long lasting, and treatment
is usually repeated every 3 to 4 months. Physical or occupational therapy
usually is undertaken to stretch and restore normal muscle function. Some
patients develop antibodies to the toxin over time, rendering the treatment
ineffective.
How are botulinum toxin injections given?
Botulinum toxin is mixed with saline (salt water) and injected into the
muscle with a tiny needle. You may receive 5 to 10 injections.
You might have some soreness at the injection sites. If your injection
sites get sore, you can take acetaminophen (one brand name: Tylenol)
or ibuprofen (one brand name: Motrin). You can also put an ice pack on the
painful area.
Will I have any side effects?
You might have weakness in the muscles that were injected, muscle soreness
that may affect your whole body, difficulty swallowing or a red rash that
lasts several days after the injections. Some people have severe weakness
in the muscles that were injected. All side effects go away quickly. The
most frequently reported adverse reactions in patients with cervical dystonia
are dysphagia (19%), upper respiratory infection (12%), neck pain (11%),
and headache (11%). The most frequently reported adverse reactions in patients
with blepharospasm are drooping of the eyelid (21%), superficial punctate
keratitis (6%), and eye dryness (6%). Patients with neuromuscular disorders
may be at increased risk of clinically significant systemic effects including
severe dysphagia and respiratory compromise from typical doses of Botulinum. |