Disorders with Excessive Muscle Contraction: Candidates for Treatment with Intramuscular Botulinum Toxin (“Botox”)

  • Mitchell F. Brin
  • Andrew Blitzer
  • Celia Stewart
  • Zachary Pine
  • Joanne Borg-Stein
  • James Miller
  • Nagalapura S. Viswanath
  • David B. Rosenfield


The initial clinical use of local injections of type A botulinum toxin (botox) was for the treatment of strabismus.1 The intended goal was to block acetylcholinergic neuromuscular junctions and rebalance neural input to the extraocular rectus muscles; this enhanced convergence.2 Several drugs, including alpha-bungarotoxin, had been considered prior to botox, but each had limitations. These included lack of selectivity, undesired side effects, short duration of action, and substantial antigenicity. Botox has the advantage of being apotent neuromuscular blocking agent while not suffering as many limitations as other putative therapeutic agents.


Botulinum Toxin Essential Tremor Cervical Dystonia Hemifacial Spasm Intrathecal Baclofen 
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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Mitchell F. Brin
    • 1
  • Andrew Blitzer
    • 2
  • Celia Stewart
    • 1
    • 2
  • Zachary Pine
    • 3
  • Joanne Borg-Stein
    • 4
  • James Miller
    • 1
  • Nagalapura S. Viswanath
    • 5
  • David B. Rosenfield
    • 5
  1. 1.Department of NeurologyColumbia Presbyterian Medical CenterNew YorkUSA
  2. 2.OtolaryngologyColumbia Presbyterian Medical CenterNew YorkUSA
  3. 3.Rehabilitation MedicineColumbia University College of Physicians and Surgeons, Columbia Presbyterian Medical CenterNew YorkUSA
  4. 4.Department of Rehabilitation MedicineTufts UniversityBostonUSA
  5. 5.Stuttering Center Speech Motor-Control Laboratory, Department of NeurologyBaylor College of Medicine & the Methodist HospitalHoustonUSA

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