Therapeutic Botulinum Toxin: Histologic Effects and Diffusion Properties

  • Gary E. Borodic
  • L. Bruce Pearce
  • Robert Ferrante


Since the introduction of botulism toxin into therapeutic medicine in 1978,1,2 the use of this drug has been expanded to other indications including blepharospasm, adult onset spasmodic torticollis, spasmodic dysphonia, occupational hand disease and jaw dystonia. Application of this therapy to other disorders is on the horizon and is further contributing to the driving force for expansion of clinical and basic research. However, despite the success obtained with botulinum toxin for treatment of blepharospasm and other focal and segmental movement disorders, its application is limited by the following properties of the therapy:
  1. 1.

    Repeated injections are required indefinitely when treating chronic disease.

  2. 2.

    Untoward spread of toxin to other muscles not targeted for injection.

  3. 3.

    Antibody formation with resistance to the therapeutic action of the toxin subsequent to repeated injections.

  4. 4.

    The consistency of biologic activity contained within the labeled vials.

  5. 5.

    Lack of standardization of the injections sites for the treatment of each syndrome.

  6. 6.

    Placement of the therapeutic toxin preparation into the correct anatomic position when access to the muscles is difficult requiring teflon coated electromyographic assistance (particularly for treatment of occupational hand disorders).

  7. 7.

    Adequate understanding of long term effects of repeated treatment with the therapeutic preparation.



Botulinum Toxin Botulinum Toxin Injection Hemifacial Spasm Motor Point Fiber Atrophy 
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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • Gary E. Borodic
    • 1
  • L. Bruce Pearce
    • 2
  • Robert Ferrante
    • 3
  1. 1.Department of OphthalmologyMassachusetts Eye and Ear InfirmaryUSA
  2. 2.Department of PharmacologyBoston University School of MedicineUSA
  3. 3.Department of Neuropathology, Massachusetts General HospitalHarvard Medical SchoolUSA

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