Nervenheilkunde 2015; 34(10): 791-797
DOI: 10.1055/s-0038-1627634
Update Neurologie und Psychiatrie
Schattauer GmbH

Botulinumtoxintherapie

Botulinum neurotoxin therapy
H. Hefter
1   Neurologische Klinik des Universitätsklinikums Düsseldorf
› Author Affiliations
Further Information

Publication History

eingegangen am: 27 July 2015

angenommen am: 28 July 2015

Publication Date:
22 January 2018 (online)

Zusammenfassung

Botulinumtoxin-A (BTX-A) weist ein enorm breites Indikationsspektrum auf. In den vergangenen Jahren wurde BTX-A auch für die Behandlung der chronischen Migräne und des spastischen Spitzfußes zugelassen. BTX-A kann also vom Kopf bis zum Fuß angewendet werden. Erstaunlicherweise sprechen sogar Symptome wie die Depression auf die äußerliche Anwendung von BTX-A an. Das Spektrum der Symptome, auf die BTX eine Wirkung zeigt, ist noch sehr viel breiter als das Spektrum der zugelassenen Indikationen. Je mehr aber BTX-A angewendet wird, desto wichtiger ist es, Immunität gegen BTX zu vermeiden, denn die Induktion von neutralisierenden Antikörpern ist der wesentliche limitierende Faktor in der Langzeitanwendung von BTX. Mit der vorliegenden Übersicht sollen einige der neuen Aspekte der BTX-A-Therapie etwas intensiver beleuchtet werden.

Summary

Botulinum neurotoxin type A (BTX-A) therapy covers a wide range of indications. Meanwhile, BTX-A is also licensed for the treatment of chronic migraine as well as the spastic drop foot. Thus BTX-A can be applied from the head to the foot. It does not only have beneficial effects on muscle hyperactivity and muscular hypertension but can also be used for the treatment of pain syndromes. Furthermore, BTX-A injections to the face also improve depression. Indeed, it is really fascinating to see, which symptoms respond to BTX-A injections. Therefore it is highly relevant to take into account and to analyze antibody formation in detail, since the development of neutralizing antibodies is the most limiting factor in BTX long-term therapy. The following up-date will highlight some of the above mentioned aspects of BTX-A application.

 
  • Literatur

  • 1 Aurora SK, Dodick DW, Turkel CC, DeGryse RE, Silberstein SD, Lipton RB. et al. Onabotulinumtoxin A for treatment of chronic migraine: Results from the double-blind, randomized, placebo-controlled phase of the PREEMPT I trial. Cephalalgia 2010; 30 (07) 793-803.
  • 2 Diener HC, Dodick DW, Aurora SK, Turkel CC, DeGryse RE, Lipton RB. et al. OnabotulinumtoxinA for treatment of chronic migraine: Results from the double-blind, randomized, placebo-controlled phase of the PREEMPT II trial. Cephalalgia 2010; 30 (07) 804-814.
  • 3 Aurora SK, Winner P, Freemean MC, Spierings EL, Heiring JO, DeGryse RE. et al. OnabotulinumtoxinA for treatment of chronic migraine: Pooled analyses of the 56-week PREEMPT clinical program. Headache 2011; 49: 1-16.
  • 4 Wollmer A, de Boer C, Kalak N, Beck J, Götz T, Schmidt T. et al. Facing depression with botulinum toxin: A randomized controlled trial. J Psychiatric Research 2012; 46: 574-581.
  • 5 Darwin C. The expression of the Emotions in Man and Animals. London: Murray; 1872
  • 6 James W. The principles of psychology. New York: Holt; 1890
  • 7 Schwartz GE, Fair PL, Salt P, Mandel MR, Klerman GL. Facial muscle patterning to affective imagery in depressed and nondepressed subjects. Science 1976; 192: 489-491.
  • 8 Carruthers JD, Carruthers JA. Treatment of glabellar frown lines with C botulinum-A exotoxin. L Dermatologic Surgery & Oncology 1992; 18: 17-21.
  • 9 Heckmann M, Teichmann B, Schöder U, Sprengelmeyer R, Ceballos-Baumann AO. Pharmacologic denervation of frown muscles enhances baseline expression of happiness and decreases baseline expression of anger, sadness, and fear. J Am Acad Dermatol 2003; 49: 213-216.
  • 10 Davis JI, Senghas A, Brandt F, Ochsner KN. The effects of BOTOX injections on emotional experience. Emotion 2010; 10: 433-440.
  • 11 Sommer B, Zschoke I, Bergfeld D, Sattler G, Augustin M. Satisfaction of patients after treatment with botulinum toxin for dynamic facial lines. Dermatologic Surgery 2003; 29: 456-460.
  • 12 Lewis MB, Bowler PJ. Botulinum toxin cosmetic therapy correlates with a more positive mood. J Cosmetic Dermatology 2009; 08: 24-26.
  • 13 Neal DT, Chartrand TL. Embodied emotion perception: amplifying and da mpening facial feedback modulates emotion perception accuracy. Science. 2011 1948550611406138..
  • 14 Hennenlotter A, Dresel C, Castrop F, Ceballos-Baumann AO, Wohlschläger AM, Haslinger B. The link between facial feedback and neural activity within central circuitries of emotion-new insights from botulinum toxin-induced denervation of frown muscles. Cerebral Cortex 2009; 19: 537-542.
  • 15 Finzi E, Wasserman E. Treatment of depression with botulinum toxin A: a case series. Dermatologic Surgery 2006; 32: 645-649.
  • 16 Hefter H. Update Botulinumtoxintherapie. Nervenheilkunde 2012; 31: 685-691.
  • 17 Reichel G. Cervical dystonia: A new phenomenological classification for botulinum toxin therapy. Basal Ganglia 2011; 01: 5-12.
  • 18 Hefter H, Blondin D, Kahlen U, Moll M, Antoch G, Schek J. CT-guided intramuscular botulinum toxin A injections into the deep anterior neck muscles in patients with pure antecaput or antecollis. Basal Ganglia 2012; 02 (02) 97-101.
  • 19 Hefter H, Kahlen U, Menge T, Rosenthal D, Moll M. Impact of posterior neck muscle treatment on cervical dystonia: Necessity to differentiate between abnormal positions of head and neck. Basal Ganglia 2012; 02 (02) 103-107.
  • 20 Hefter H. Notwendigkeit einer statistisch präzisen Analyse der Bildungswahrscheinlichkeit neutralisierender Antikörper in der Botulinumtoxin-Therapie. Thieme Drug Report 2014; 07 (08) 1-12.