What is the minimum dosis of botulinum toxin to completely paralyze muscles of the upper limb?
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Answer:
What is the minimum dosis of botulinum toxin to completely paralyze muscles of the upper limb?
Wide range of dosages of botulinum toxin are used to partially paralyze arm muscles varying from patient to patient in indications arm spasticity, dystonia, tremor etc. Injection guidance and dose recommendations are established for specific indications (e.g. spasticity) backed by evidence from clinical studies. In other indications (e.g. essential, dystonic or parkinson tremor) no such evidence based guidances exist. Treatment approaches are therefore diverse (booster injections, fixed dosages to specified muscles, costumization of muscles and dosages based on visual or technical measurement of tremor severity and type).
Explanation:
Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C1, C2, D, E, F and G). All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about three months. Botulinum toxins now play a very significant role in the management of a wide variety of medical conditions, especially strabismus and focal dystonias, hemifacial spasm, and various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond only partially to medical treatment. The list of possible new indications is rapidly expanding. The cosmetological applications include correction of lines, creases and wrinkling all over the face, chin, neck, and chest to dermatological applications such as hyperhidrosis. Injections with botulinum toxin are generally well tolerated and side effects are few. A precise knowledge and understanding of the functional anatomy of the mimetic muscles is absolutely necessary to correctly use botulinum toxins in clinical practice.