Botulinum Toxin in Neurology

Written by: Dr. Antonio Yusta Izquierdo
Edited by: Top Doctors®

Botulinum Toxin is a very potent poison produced by a bacterium, Clostridium botulinum. This toxin causes muscular paralysis and is responsible for causing Botulism, a life-threatening disease, although the doses for its application as medical therapy pose no danger to humans.

Beyond cosmetic surgery

The aesthetic use of this substance is the best known among today's society. However, this perception is very far from reality. Ophthalmologists were the first to use Botulinum Toxin to improve strabismus. Then the neurologists began to use it to treat certain movement disorders such as dystonias in the arms and legs and, later, in patients with spasticity. Aesthetic medicine was the third to arrive.

The reality is that Botulinum Toxin is a medical therapy and its use in aesthetic medicine is much less frequent than that used in neurology. On the one hand because very little amount is used, since in each session of Neurology, between 100 and 200 units of the substance are used compared to the 50 units used in Plastic Surgery.. On the other hand, because the largest volume of treatments using Botulinum Toxin is given to treat neurological diseases.


Individualize the treatment

Although there are action protocols, treatment must be individualized according to each patient. Not all spasticity is the same, not all muscle tone increase is the same nor does each migraine manifest in the same way. Therefore it is the responsibility of the neurologist to develop a personalized treatment.

In a treatment with Botulinum Toxin the union between the nerve and the muscle is "broken" producing a weakness in the latter. So when applied to the right muscle, the specific pathology improves a lot.

Normally Botulinum Toxin is used in a repetitive treatment for a certain period of time, until the muscle returns to normal function, or until there is no possibility of reinnervation.  


Direct application or through EMG

At the time of applying Botulinum Toxin the role of the specialist is very important. Above all, you must know the muscles and function of the muscle that you are going to inject. The muscles can be superficial or deep. The superficial ones are under the skin and can be felt, so that the application of the toxin is direct.

In contrast, the deep ones (in the back of the thigh, the leg or in some forearm muscles) or in people with a thick adipose panniculus, it is necessary to use an electromyograph to detect the contraction of the muscle to which we want to inject the toxin.. Thanks to this technique we can inject the toxin into the right muscle, so that the effectiveness of the treatment is higher.   

In this field, the most significant advance, aside from the fact that more and more pathologies are known in which botulinum toxin can be used effectively, would be the follow-up of Toxin injection by ultrasound control for these deep muscles.


*Translated with Google translator. We apologize for any imperfection

By Dr. Antonio Yusta Izquierdo

Dr. Antonio Izquierdo Yusta a doctorate Cum Laude and a specialist in Neurology. He is an expert in the treatment of multiple sclerosis, headaches and epilepsy. Apply all treatments with botulinum toxin. Currently she combines teaching with his position as Chief of Neurology, University Hospital of Guadalajara.

*Translated with Google translator. We apologize for any imperfection

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