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Toxins Nov 2017Essential tremor is characterized by persistent, usually bilateral and symmetric, postural or kinetic activation of agonist and antagonist muscles involving either the... (Review)
Review
Essential tremor is characterized by persistent, usually bilateral and symmetric, postural or kinetic activation of agonist and antagonist muscles involving either the distal or proximal upper extremity. Quality of life is often affected and one's ability to perform daily tasks becomes impaired. Oral therapies, including propranolol and primidone, can be effective in the management of essential tremor, although adverse effects can limit their use and about 50% of individuals lack response to oral pharmacotherapy. Locally administered botulinum toxin injection has become increasingly useful in the management of essential tremor. Targeting of select muscles with botulinum toxin is an area of active research, and muscle selection has important implications for toxin dosing and functional outcomes. The use of anatomical landmarks with palpation, EMG guidance, electrical stimulation, and ultrasound has been studied as a technique for muscle localization in toxin injection. Earlier studies implemented a standard protocol for the injection of (predominantly) wrist flexors and extensors using palpation and EMG guidance. Targeting of muscles by selection of specific activators of tremor (tailored to each patient) using kinematic analysis might allow for improvement in efficacy, including functional outcomes. It is this individualized muscle selection and toxin dosing (requiring injection within various sites of a single muscle) that has allowed for success in the management of tremors.
Topics: Botulinum Toxins; Electric Stimulation; Electromyography; Extremities; Humans; Tremor
PubMed: 29125566
DOI: 10.3390/toxins9110365 -
Journal of Cosmetic Dermatology Sep 2020The globally devastating effects of COVID-19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the... (Review)
Review
BACKGROUND
The globally devastating effects of COVID-19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the advent of mask-wearing.
METHODS
A review of the literature and understanding of facial anatomy and expressions as well as the effect of botulinum toxin on emotions and nonverbal communication.
RESULTS
Today, the mask has become a semi-permanent accessory to the face, blocking our ability to express and perceive each other's facial expressions by dividing it into a visible top half and invisible bottom half. This significantly restricts our ability to accurately interpret emotions based on facial expressions and strengthens our perceptions of negative emotions produced by frowning. The addition of botulinum toxin (BTX)-induced facial muscle paralysis to target the muscles of the top (visible) half of the face, especially the corrugator and procerus muscles, may act as a therapeutic solution by its suppression of glabellar lines and our ability to frown. The treatment of the glabella complex not only has been shown to inhibit the negative emotions of the treated individual but also can reduce the negative emotions in those who come in contact with the treated individual.
CONCLUSIONS
Mask-wearing in the wake of COVID-19 brings new challenges to our ability to communicate and perceive emotion through full facial expression, our most effective and universally shared form of communication, and BTX may offer a positive solution to decrease negative emotions and promote well-being for both the mask-wearer and all who come in contact with that individual.
Topics: Botulinum Toxins; COVID-19; Emotions; Facial Expression; Facial Muscles; Forehead; Humans; Masks; Nonverbal Communication; SARS-CoV-2
PubMed: 32592268
DOI: 10.1111/jocd.13569 -
Frontiers in Public Health 2022Botulinum toxin A(BoNT/A) is a neurotoxin produced by the bacteria , which can cause serious food poisoning and is recognized as a potential biological warfare agent....
Botulinum toxin A(BoNT/A) is a neurotoxin produced by the bacteria , which can cause serious food poisoning and is recognized as a potential biological warfare agent. BoNT/A is does not degrade easily and can remain in the complex matrix for a long time. Meanwhile, the poisonous dose of botulinum toxin exceptionally low and intravenous human lethal doses estimated at 1-3 ng/kg. Therefore, sensitive and accurate detection methods suitable for testing a wide range of complex samples are urgently needed. To this end, the "amplified luminescent proximity homogeneous assay linked immunosorbent assay" (AlphaLISA) was established for the detection of BoNT/A and its detection efficacy in plasma, beverage, food, and other complex samples was evaluated. The results showed that this method can very effectively resist matrix interference. The detection time is rapid, reaching a detection limit for all samples of up to 0.1 ng/mL in only 30 min. BoNT/A can also be accurately detected in vomit samples of patients with clinical food poisoning. This study demonstrates that AlphaLISA is an effective tool for the detection of BoNT/A in complex samples and can potentially be developed for commercial use in the future.
Topics: Humans; Botulinum Toxins, Type A; Clostridium botulinum; Foodborne Diseases
PubMed: 36339146
DOI: 10.3389/fpubh.2022.987517 -
Journal of Integrative Neuroscience Jan 2022Botulinum toxin (BT) is a neurotoxin produced by Clostridium botulinum, a gram-positive anaerobic bacterium. Systemic human intoxication from BT following oral ingestion... (Review)
Review
Botulinum toxin (BT) is a neurotoxin produced by Clostridium botulinum, a gram-positive anaerobic bacterium. Systemic human intoxication from BT following oral ingestion results in acute and life-threatening muscle paralysis called botulism. BT has a wide scope of therapeutic uses, including conditions associated with increased muscle tone, smooth muscle hyperactivity, salivation, sweating, and allergies, as well as for cosmetic purposes. Several commercial forms of BT are available for medical use, including Botox (onabotulinumtoxinA). Multiple studies have found evidence of an analgesic effect of onabotulinumtoxinA and demonstrated the benefits of its use for the treatment of various chronic pain disorders. In this review, we provide an update on the use of onabotulinumtoxinA for the treatment of headache disorders.
Topics: Botulinum Toxins, Type A; Headache Disorders; Humans; Neuromuscular Agents
PubMed: 35164473
DOI: 10.31083/j.jin2101037 -
Journal of Neural Transmission (Vienna,... Oct 2022Cell-based assays are a novel method to determine potency of botulinum toxin drugs. Manufacturers are working on their acquisition, development and implementation to...
Cell-based assays are a novel method to determine potency of botulinum toxin drugs. Manufacturers are working on their acquisition, development and implementation to reduce animal consumption during the manufacturing process. Potency labelling of botulinum toxin drugs differes principally between Ipsen and the other manufacturers. Reference to a uniform international standard would avoid this potentially dangerous situation. However, this has not been demanded by the registration authorities and has not been persued by the manufacturers for decades.
Topics: Animals; Botulinum Toxins, Type A
PubMed: 36040625
DOI: 10.1007/s00702-022-02535-z -
Toxins Aug 2021The COVID-19 pandemic severely impacted the function of medical facilities and rehabilitation services worldwide, including toxin services delivering Botulinum toxin...
The COVID-19 pandemic severely impacted the function of medical facilities and rehabilitation services worldwide, including toxin services delivering Botulinum toxin treatments for neuromuscular conditions such as spasticity, dystonia, and sialorrhea. The aim of this paper is to understand how toxin services have dealt with the situation and what strategies have been adopted to continue services. The recommendations are based on a virtual round table held with toxin services experts from different European countries who shared their experiences and discussed the best practices. The challenges for toxin services were reviewed based on the experts' experiences and on relevant literature from 2020 and 2021. A set of recommendations and best practices were compiled, focusing firstly on guidance for clinical practice, including assessing patients' health and risk status and the urgency of their treatment. Secondly, it was discussed how patients on botulinum toxin therapy can be cared for and supported during the pandemic, and how modern technology and tele-medicine platforms can be generally used to optimize effectiveness and safety of toxin treatments. The technological advances prompted by the COVID-19 crisis can result in better and more modern patient care in the future.
Topics: Botulinum Toxins; COVID-19; Europe; Humans; Neuromuscular Diseases; Rehabilitation Centers; SARS-CoV-2; Telemedicine
PubMed: 34437456
DOI: 10.3390/toxins13080584 -
Journal of Neurology, Neurosurgery, and... Aug 2000
Topics: Botulinum Toxins; Botulinum Toxins, Type A; Cerebral Palsy; Chemotherapy, Adjuvant; Electric Stimulation Therapy; Humans; Multiple Sclerosis; Muscle Spasticity; Neuromuscular Agents; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Stroke
PubMed: 10896682
DOI: 10.1136/jnnp.69.2.143 -
Saudi Journal of Gastroenterology :... 2022
Topics: Botulinum Toxins; Humans; Stomach; Treatment Outcome
PubMed: 35848699
DOI: 10.4103/sjg.sjg_261_22 -
Microbiological Reviews Mar 1992Crystalline botulinum toxin type A was licensed in December 1989 by the Food and Drug Administration for treatment of certain spasmodic muscle disorders following 10 or... (Comparative Study)
Comparative Study Review
Crystalline botulinum toxin type A was licensed in December 1989 by the Food and Drug Administration for treatment of certain spasmodic muscle disorders following 10 or more years of experimental treatment on human volunteers. Botulinum toxin exerts its action on a muscle indirectly by blocking the release of the neurotransmitter acetylcholine at the nerve ending, resulting in reduced muscle activity or paralysis. The injection of only nanogram quantities (1 ng = 30 mouse 50% lethal doses [U]) of the toxin into a spastic muscle is required to bring about the desired muscle control. The type A toxin produced in anaerobic culture and purified in crystalline form has a specific toxicity in mice of 3 x 10(7) U/mg. The crystalline toxin is a high-molecular-weight protein of 900,000 Mr and is composed of two molecules of neurotoxin (ca. 150,000 Mr) noncovalently bound to nontoxic proteins that play an important role in the stability of the toxic unit and its effective toxicity. Because the toxin is administered by injection directly into neuromuscular tissue, the methods of culturing and purification are vital. Its chemical, physical, and biological properties as applied to its use in medicine are described. Dilution and drying of the toxin for dispensing causes some detoxification, and the mouse assay is the only means of evaluation for human treatment. Other microbial neurotoxins may have uses in medicine; these include serotypes of botulinum toxins and tetanus toxin. Certain neurotoxins produced by dinoflagellates, including saxitoxin and tetrodotoxin, cause muscle paralysis through their effect on the action potential at the voltage-gated sodium channel. Saxitoxin used with anaesthetics lengthens the effect of the anaesthetic and may enhance the effectiveness of other medical drugs. Combining toxins with drugs could increase their effectiveness in treatment of human disease.
Topics: Bacterial Toxins; Botulinum Toxins; Humans; Muscular Diseases; Neurotoxins; Saxitoxin; Tetrodotoxin; Virulence Factors, Bordetella
PubMed: 1579114
DOI: 10.1128/mr.56.1.80-99.1992 -
Toxins Apr 2018Botulinum toxins (BoNTs) are produced by several anaerobic species of the genus and, although they were originally considered lethal toxins, today they find their... (Review)
Review
Botulinum toxins (BoNTs) are produced by several anaerobic species of the genus and, although they were originally considered lethal toxins, today they find their usefulness in the treatment of a wide range of pathologies in various medical specialties. Botulinum neurotoxin has been identified in seven different isoforms (BoNT-A, BoNT-B, BoNT-C, BoNT-D, BoNT-E, BoNT-F, and BoNT-G). Neurotoxigenic Clostridia can produce more than 40 different BoNT subtypes and, recently, a new BoNT serotype (BoNT-X) has been reported in some studies. BoNT-X has not been shown to actually be an active neurotoxin despite its catalytically active LC, so it should be described as a putative eighth serotype. The mechanism of action of the serotypes is similar: they inhibit the release of acetylcholine from the nerve endings but their therapeutically potency varies. Botulinum toxin type A (BoNT-A) is the most studied serotype for therapeutic purposes. Regarding the gynecological pathology, a series of studies based on the efficiency of its use in the treatment of refractory myofascial pelvic pain, vaginism, dyspareunia, vulvodynia and overactive bladder or urinary incontinence have been reported. The current study is a review of the literature regarding the efficiency of BoNT-A in the gynecological pathology and on the long and short-term effects of its administration.
Topics: Animals; Botulinum Toxins; Female; Genital Diseases, Female; Humans
PubMed: 29690530
DOI: 10.3390/toxins10040169