ABSTRACT
Botulinum toxin inhibits the vesicular release of acetylcholine in the neuromuscular
junction, resulting in a transient, localized paralysis when small doses are injected.
The successful use of serotypes A and B in conditions with muscle overactivity such
as dystonia and spasticity has been well established. Apart from approved indications,
treatment with botulinum toxin injections is attempted in a variety of new areas of
neurology, including tremor, tics, and myoclonus. This article provides an update
on the uses of botulinum toxin in the field of movement disorders and draws special
attention to theoretical and practical treatment issues of primary and secondary dystonic
disorders. Long-term experience with this agent suggests that it is an effective and
safe treatment not only for approved indications but also for the increasing number
of off-label indications. However, controlled studies for many conditions are lacking,
and more clinical trials in many different areas are warranted.
KEYWORDS
Botulinum toxin - movement disorders - dystonia
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Spiridon PapapetropoulosM.D. Ph.D.
Assistant Professor of Neurology, Division of Movement Disorders, University of Miami,
School of Medicine
1501 NW 9th Avenue, Miami, FL 33136
