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Therapeutic Botulinum Toxin: Histologic Effects and Diffusion Properties

  • Chapter
Botulinum and Tetanus Neurotoxins

Abstract

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.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, USA

    Gary E. Borodic

  2. Department of Pharmacology, Boston University School of Medicine, USA

    L. Bruce Pearce

  3. Department of Neuropathology, Massachusetts General Hospital, Harvard Medical School, USA

    Robert Ferrante

Authors
  1. Gary E. Borodic
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  2. L. Bruce Pearce
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  3. Robert Ferrante
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Editor information

Editors and Affiliations

  1. University of Wisconsin, Madison, Wisconsin, USA

    Bibhuti R. DasGupta

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© 1993 Springer Science+Business Media New York

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Borodic, G.E., Pearce, L.B., Ferrante, R. (1993). Therapeutic Botulinum Toxin: Histologic Effects and Diffusion Properties. In: DasGupta, B.R. (eds) Botulinum and Tetanus Neurotoxins. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-9542-4_70

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  • DOI: https://doi.org/10.1007/978-1-4757-9542-4_70

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-9544-8

  • Online ISBN: 978-1-4757-9542-4

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