The clinical use of botulinum toxin
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| Format: | Buch |
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| Sprache: | English |
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Philadelphia [u.a.]
Saunders
2004
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| Schriftenreihe: | Dermatologic clinics of North America
22,2 |
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| 245 | 1 | 0 | |a The clinical use of botulinum toxin |c Arnold W. Klein, guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2004 | |
| 300 | |a VIII S., S. 132 - 230 |b Ill. | ||
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| 490 | 1 | |a Dermatologic clinics of North America |v 22,2 | |
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Datensatz im Suchindex
| _version_ | 1819654388848787456 |
|---|---|
| adam_text | CONTENTS
Preface ix
Arnold W. Klein
Development of Botulinum Toxin Therapy 131
Alan B. Scott
Justinius Kerner collected data on 230 cases of botulism in the 1820s, suggested the thera¬
peutic use of toxin, and gave a remarkably complete and accurate description of clinical bot¬
ulism: its symptoms, time course, and the physical findings that the tear fluid disappears,
the skin is dry, the eye, gut, and somatic muscles are paralyzed, and mucus and saliva secre¬
tion is suppressed. These effects are the clinical targets of botulinum therapy today. Inspired
by Drachman s use of toxin to safely paralyze the hind limb in chicks, we worked out the
procedures for its safe medical application and licensure from 1972 to 1989, applying it first
to correct strabismus, blepharospasm, leg muscle spasm, and torticollis. This list is now
extended by others to well over 100 uses. For many years, blepharospasm patients return¬
ing for injection around the eyes and upper face would mention as a joke that they were
back to get the wrinkles out. Working in aesthetic dermatology and ophthalmology,
Alistair and Jean Carruthers could envision the intentional cosmetic application of botu¬
linum toxin, probably its greatest single use today.
Dilution, Storage, and Electromyographic Guidance in the Use of Botulinum Toxins 135
Alan M. Mantell
Botulinim toxin A (BTX A) is available commercially in two formulations: Botox®
(Allergan, Inc. Irvine, California) and Dysport® (Ipsen Limited, Berkshire, United
Kingdom). To use BTX A successfully for cosmetic purposes, it is important to under¬
stand the basic principles of BTX A therapy and the specific guidelines for its use, includ¬
ing dilution and storage. Injection using electromyographic guidance is helpful in
achieving correct placement of BTX A by locating the muscle responsible for a particu¬
lar facial line.
Botulinum Toxin Type A for the Treatment of Glabellar Rhytides 137
Alastair Carruthers and Jean Carruthers
Since the introduction of botulinum toxin type A (BTX A) more than 20 years ago, its use
has expanded to include a wide range of clinical applications for the aging face.
Although its use in facial rejuvenation initially provoked amazement in the general pop¬
ulation, BTX A injections have become an accepted part of cosmetic practice. Glabellar
VOLUME 22 • NUMBER 2 • APRIL 2004 v
frown lines were the focus of the initial cosmetic investigations and are still the most
common site for BTX A injections. This article reviews the start of this process and
reviews current clinical procedures and experience.
Botox for the Eyes and Eyebrows 145
Arnold W. Klein
The forehead and crow s feet (periorbital wrinkles) are among areas where Botox has been
quite helpful. This cosmetic use is not approved by the Food and Drug Administration and
is considered off label. The effect, although temporary, is extremely popular with patients,
has a very low incidence of side effects, and is a relatively easy technique to acquire.
Botulinum Toxin A in the Mid and Lower Face and Neck 151
Jean Carruthers and Alastair Carruthers
Although once considered a novel concept, the use of botulinum neurotoxins to smooth
hyperkinetic lines in the upper face has become an accepted and successful procedure in
facial rejuvenation. In the mid and lower face and neck, botulinum toxin injections can
diminish rhytides and sculpt the face into more aesthetically pleasing lines. The doses
used in the mid and lower face and neck differ greatly from those in the upper face, and
only experienced clinicians with a detailed understanding of the underlying muscular
anatomy and tissue relationships should inject in areas associated with more risk of
potential complications. This article reviews current approaches to botulinum toxins as
primary and adjunctive therapies in the mid and lower face and neck.
Botulinum Toxin for the Treatment of Neck Lines and Neck Bands 159
Fredric S. Brandt and Andres Boker
The use of botulinum toxin injections for rejuvenating the aging neck has yielded very
satisfactory results. Our vast experience with botulinum toxins type A and B has helped
describe the ideal clinical outcome as well as possible and expected side effects of the
treatment. This procedure is a safe and effective therapeutic modality for all patients
desiring an improvement in the cosmetic appearance of their neck, but who at the same
time do not desire any recuperation time or are unwilling to undertake the potential side
effects associated with plastic surgery procedures.
Botulinum Neurotoxin for the Treatment of Migraine and Other Primary
Headache Disorders 167
Andrew M. Blumenfeld, David W. Dodick, and Stephen D. Silberstein
Botulinum toxin A (BoNT A), a neurotoxin, is effective for treating a variety of involun¬
tary muscle contraction disorders, including cervical dystonia, blepharospasm, and
hemifacial spasm. Recently, clinical findings suggest that BoNT A may inhibit pain asso¬
ciated with migraine and other headache types. A number of retrospective, open label
chart reviews and three placebo controlled, double blind trials have demonstrated that
localized injections of BoNT A significantly reduce migraine frequency, severity, and
migraine associated disability. There are currently four randomized, placebo controlled
clinical trials in progress evaluating the efficacy, optimal dosing, and side effect profile
of this toxin as a novel treatment for migraine and other headache types. These studies
may provide further evidence that BoNT A is an effective option for the preventive treat¬
ment of migraine.
Treatment of Hyperhidrosis with Botulinum Toxin 177
Richard G. Glogau
Focal idiopathic and episodic eccrine sweating of the axillae, palms, soles, and face troubles
afflicted individuals with a social curse that can only be imagined by those whose hands or
underarms dampen only occasionally. Although there is no accurate incidence in the epi¬
demiology literature, it seems that about half of the patients who have presented to the
author with this condition have at least one first degree relative similarly affected. Social
stigma, lack of understanding on the part of medical providers as to the cause and nature
of the problem, and lack of effective therapy keeps most of these patients from seeking med¬
ical care. This article investigates the treatment of hyperhidrosis with botulinum toxin,
Noncosmetic Uses of Botulinum Toxin 187
Craig Zalvan, Boris Bentsianov, Omar Gonzalez Yanes, and Andrew Blitzer
Since the introduction of botulinum toxin as a therapeutic tool in the 1970s, the number
of uses for this drug has increased exponentially. The mechanism of action of the toxin is
to degrade the SNARE proteins blockading the release of acetylcholine into the neuro
muscular junction. In many body systems, decrease of contractility, strength, and tension
of certain muscle groups result in improved clinical outcomes. Applications now include
cosmetic, gastroenterologic, otolaryngologic, genitourinary, neurologic, and dermatologic
use. In fact, in any situation with inappropriate or exaggerated muscle contraction, bot¬
ulinum toxin can be considered as a potential treatment. The toxins effect on SNARE
proteins may also inhibit the release of pain mediators and block autonomic nervous sys¬
tem effects such as in hyperhidrosis. Currently, the Food and Drug Administration
(FDA) has licensed botulinum toxin A (Botox®) for the treatment of glabelar lines, ble
pharospasm, strabismus, hemifacial spasm, cervical dystonia, and spasticity. With the
recent addition of cosmetic applications to the FDA s approval list, the use of botulinum
toxin has dramatically increased. Review of the literature now shows hundreds of arti¬
cles with novel ideas for the use of botulinum toxin. However, the vast majority of these
articles are anecdotal, with few randomized, controlled, and blinded studies.
Complications with the Use of Botulinum Toxin 197
Arnold W. Klein
This article discusses complications with the use of botulinum toxin. The following
topics are explored: conditions caused by muscle spasms, resistance to botulinum toxin,
cosmetic use of botulinum toxin, complications in treating hyperhidrosis, treatment of
migraine headaches, and informed consent.
Myobloc 207
Timothy Corcoran Flynn
Myobloc is the currently available commercial formulation of type B botulinum toxin.
Released in the United States in 2000, it is approved by the Food and Drug
Administration for the treatment of cervical dystonia. The most commonly used botu¬
linum toxins, the type A toxins (Botox® and Dysport®), affect the SNAP 25 protein,
whereas the type B toxin (Myobloc®) affects vesicle associated membrane protein, also
known as synaptobrevin. Both type B and type A are antigenically distinct. This article
explains the difference between Myobloc® and type A toxins, reviews equivalency and
other published studies, and describes practical uses for this product in facial aesthetics.
Dysport 213
Andrew C. Mar key
Clinical experience using botulinum toxin A (BTX A) in North America mainly relates
to the Botox® product produced by Allergan Inc., USA. In Europe, a different BTX A
product named Dysport® produced by Ipsen Ltd. has been extensively used over a
similar period. BTX A products should not be seen as generic equivalents but as indi¬
vidual products with their own efficacy and safety profiles. This article discusses the
Dysport® product history, manufacture, immunogenicity, dilution, and biologic activity.
The extensive European experience of this product by multiple specialties, including
dermatology, is documented.
Comparison of Botulinum Toxins A and B in the Treatment of Facial Rhytides 221
Neil S. Sadick and Seth L. Matarasso
Botulinum toxin injections have become the most popular aesthetic procedure for both
men and women in the United States. Following injection, the toxin weakens facial
mimetic muscles, releasing the superimposed cutaneous rhytid. Two antigenically distinct
serotypes, botulinum toxin type A (Botox®) and botulinum toxin type B (Myobloc®), are
commercially available. In addition to differences with respect to formulation, they are
pharmacologically distinct in terms of molecular size, cellular mechanism of action, and
species sensitivity. Clinical distinctions include pain on administration, onset of action,
diffusion, and duration of effect. Both agents are safe ambulatory modalities for tempo¬
rarily improving hyperkinetic facial lines.
Index 227
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| indexdate | 2024-12-23T18:02:20Z |
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| physical | VIII S., S. 132 - 230 Ill. |
| publishDate | 2004 |
| publishDateSearch | 2004 |
| publishDateSort | 2004 |
| publisher | Saunders |
| record_format | marc |
| series | Dermatologic clinics of North America |
| series2 | Dermatologic clinics of North America |
| spellingShingle | The clinical use of botulinum toxin Dermatologic clinics of North America Botulinum Toxins therapeutic use Botulinustoxin (DE-588)4273044-2 gnd Therapie (DE-588)4059798-2 gnd |
| subject_GND | (DE-588)4273044-2 (DE-588)4059798-2 |
| title | The clinical use of botulinum toxin |
| title_auth | The clinical use of botulinum toxin |
| title_exact_search | The clinical use of botulinum toxin |
| title_full | The clinical use of botulinum toxin Arnold W. Klein, guest ed. |
| title_fullStr | The clinical use of botulinum toxin Arnold W. Klein, guest ed. |
| title_full_unstemmed | The clinical use of botulinum toxin Arnold W. Klein, guest ed. |
| title_short | The clinical use of botulinum toxin |
| title_sort | the clinical use of botulinum toxin |
| topic | Botulinum Toxins therapeutic use Botulinustoxin (DE-588)4273044-2 gnd Therapie (DE-588)4059798-2 gnd |
| topic_facet | Botulinum Toxins therapeutic use Botulinustoxin Therapie |
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