Botulinum Neurotoxin is a biological product which has revolutionized the treatment of various neurological symptoms since its recognition in the late 1980s. Botulinum neurotoxin is derived from the bacterium Clostridium botulinum. There are various serotypes of this toxin, but commonly used are the Type – A and Type – B. Botulinum toxin (Brand names: Botox, Dysport, Xeomin, etc) is a nerve "blocker" that binds to the nerves that lead to the muscle and prevents the release of acetylcholine, a neurotransmitter that activates muscle contractions. If the message is blocked, muscle spasms are significantly reduced or eliminated.
Botox treatment is a well-recognized therapeutic option available since the early 1980s. In the last 30 years, it has itself established as a well-accepted treatment for various disorders based upon scientific publications and observations.
The medication is directly injected into the area of the body where a benefit is intended for. E.g., into cervical muscles in cervical dystonia and ocular muscles for blepharospasm. For selected areas of the body, and particularly when injecting muscles that are difficult or impossible to palpate, guidance using an electromyograph (EMG) may be necessary.
For instance, when injecting the deep muscles of the jaw, neck, or vocal cords, an EMG-guided injection may improve precision since these muscles cannot be readily palpated. EMG measures and records muscle activity and may help the physician locate overactive muscles. The procedure is done with a very fine needle and most of the people do not complain of any discomfort. At most the pain can be as that or less of a small mosquito bite.
It normally takes several days for the effects of the botulinum neurotoxin to become apparent. The benefit peaks in approximately four weeks and lasts three to four months. In some cases, the benefits can last between 6 to 12 months.
Temporary side effects for both types A and B may include muscle weakness, mild pain at the injection site, and dry mouth. Patients should feel free to ask their physician about additional side effects that may be specific to the body area that is to be injected--for example, temporary difficulty swallowing may occur in patients injected for laryngeal or cervical dystonias, but is highly unlikely for someone getting injected for writer's cramp.
If a patient experiences side effects, adjusting the dosage or site of injection for future treatments may help avoid these effects. As Botulinum toxin effects are temporary, most of the side effects usually resolve within days to weeks.