What is botulinum toxin?
Botulinum toxin is a substance produced by bacteria. In the case of food poisoning in ancient times, it became known through spoiled meat and sausage products. Today, the effects of botulinum toxin are used in medicine. The drug is obtained from the bacterium Clostridium botulinum and processed under strict conditions. The effects of botulinum toxin are so extreme that a few billionths of a gram are enough to relieve cramps. Therefore, botulinum toxin is a remedy for spasticity, because the overactive muscles are stimulated to relax.
Botulinum toxin - is it toxic?
It depends on the amount used. As with many natural substances, botulinum toxin is non-toxic to a certain extent. For medical treatment, botulinum toxin is manufactured in the form of a drug and injected in very small amounts. The active ingredient gets directly to the target site, i.e. to the muscle, and only acts specifically in it.
How is botulinum toxin made?
The active ingredient botulinum toxin type A is a protein produced by the bacterium Clostridium botulinum. In a complex process, the active ingredient is isolated, purified and prepared for a drug.
How does botulinum toxin work?
Botulinum toxin type A only acts at the junction between nerves and muscles. Transmission of the signal from nerve cell to muscle normally occurs at the motor endplate, whereupon the muscle is instructed to contract. The signal is transmitted via chemical messengers. In spasticity, injection of botulinum toxin controls the deregulation of neuronal signals that causes the muscle to contract abnormally. Overactive muscles can temporarily relax, thereby reducing spasticity symptoms.
How does botulinum toxin work?
An improvement can already be felt a few days after the injection. The effects of the treatment peak within a few weeks and usually last three to four months. The therapy must be repeated at regular intervals, since the effect of botulinum toxin between the nerves and muscles is only temporary and the active substance is broken down by the body.
What can botulinum toxin be used for?
Botulinum toxin type A is used in various diseases with abnormally high muscle tension, including various movement disorders such as eyelid spasms, torticollis, spasticity or multiple sclerosis.
When should you not use botulinum toxin?
Treatment with botulinum toxin should not be performed:
- if the patient has generalized muscle disease
- if the patient has Lambert-Eaton syndrome
- if you have a known hypersensitivity to the active substance or to any other component of the medication
- in case of infection or inflammation
How does the treatment work?
In order to administer the correct dose to the patient, the doctor has to determine this using various examinations. To do this, the state of tension and function of the muscles must be analyzed. The active ingredient botulinum toxin is injected directly into the over-excited muscles. This relieves muscle tension and reduces involuntary movements. With each treatment, the dose must be optimized and readjusted.
Are there any side effects?
Botulinum toxin is a prescription drug that relaxes tight muscles. In general, with its local application, the drug is well tolerated. As with all medicines, side effects can also occur when using botulinum toxin, although these do not necessarily occur in all patients. Please check the instructions for use of the prescription drug or your doctor for possible side effects. If you are affected by side effects that are not listed in the instructions for use, inform your doctor or pharmacist.
Are there side effects and interactions?
Please ask your doctor about side effects and interactions with certain muscle relaxants and medications.
Function of the muscle
How is muscle activity controlled?
Movement occurs when chemical energy is converted into mechanical energy in the muscle. Motor endplates are the transition points from muscle to nerve. In order for a controlled and desired movement to take place, the nerve must first release the chemical messenger substance acetylcholine.
What is a muscle contraction?
Muscle contraction is the active expansion and contraction of the muscle. The muscle receives the request for muscle contraction via the nerves.
What is the relationship between nerves and muscles?
The information on whether and how much the muscle should contract comes from the nerves supplying it. Nerve dysfunction also has a direct effect on muscle activity. The information about the tension is transmitted to the muscle by messenger substances from the nerve endings. If the messenger substance is no longer released, the muscle relaxes permanently.
What is an EMG?
Electromyography (EMG) can be used to measure the natural activity of the muscle, making it possible to identify diseased muscles or the associated nerves. A relaxed muscle normally shows no electrical activity in the EMG, but even the slightest contraction generates electrical voltages that can be measured. In spasticity, a striking pattern can be seen in the muscle's electrical activity. Especially when the affected muscle cannot be palpated due to spasms, the EMG is used to visually and acoustically show the overactivity of the muscle.
How does electrostimulation work?
Electrical simulations are used to identify individual muscles for botulinum toxin. A needle electrode is inserted into the muscle, which can also be used for injections. The muscle is contracted by electric currents and the correct position is checked by electrodes.
How does computed tomography (CT) work?
Computed tomography is used to identify injection muscles that are very difficult to reach, such as deep muscles in the neck. A CT begins by taking pictures of the affected areas of the body. The tense muscles are then identified and the exact puncture site is determined, for which the CT scans are also used. After the needle has been positioned exactly, the injection takes place.
How does an ultrasound (sonography) work?
In addition to electromyography, ultrasound can also be used to identify muscles. The various muscle groups and their localization can also be identified in the ultrasound image. This method is mainly used to reach the deeper muscles.
How does the diagnosis based on scales work?
Scales are used as assessment methods to uniformly assess and document different clinical pictures. These scales are essential for the success of therapy and for therapy planning. Different scales can be used to record patient feelings on the one hand and objectively measured successes on the other.
Note: For reasons of better legibility, the masculine form is used for personal designations. Corresponding terms generally apply to all genders in terms of equal treatment. The shortened form of language is for editorial reasons only and does not include any rating.