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Botulinum neurotoxin type A in neurology: update

Marco Orsini, Marco Antonio Araujo Leite, Tae Mo Chung, Wladimir Bocca, Jano Alves de Souza, Olivia Gameiro de Souza, Rayele Priscila Moreira, Victor Hugo Bastos, Silmar Teixeira, Acary Bulle Oliveira, Bruno da Silva Moraes, André Palma Matta, Luis Jorge Jacinto
  • Marco Orsini
    Centro Universitário Augusto Motta, Bonsucesso, Rio de Janeiro; Universidade Federal Fluminense, Departamento de Neurologia, Niterói, Rio de Janeiro, Brazil
  • Marco Antonio Araujo Leite
    Universidade Federal Fluminense, Departamento de Neurologia, Niterói, Rio de Janeiro, Brazil | maaraujoleite@yahoo.com.br
  • Tae Mo Chung
    Universidade de São Paulo - USP, São Paulo, Brazil
  • Wladimir Bocca
    Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
  • Jano Alves de Souza
    Universidade de São Paulo - USP, São Paulo, Brazil
  • Olivia Gameiro de Souza
    Universidade de São Paulo - USP, São Paulo, Brazil
  • Rayele Priscila Moreira
    Universidade Federal do Piaui, Parnaíba, Brazil
  • Victor Hugo Bastos
    Universidade Federal do Piaui, Parnaíba, Brazil
  • Silmar Teixeira
    Universidade Federal do Piaui, Parnaíba, Brazil
  • Acary Bulle Oliveira
    Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
  • Bruno da Silva Moraes
    Centro Universitário Augusto Motta, Bonsucesso, Rio de Janeiro, Brazil
  • André Palma Matta
    Universidade Federal Fluminense, Departamento de Neurologia, Niterói, Rio de Janeiro, Brazil
  • Luis Jorge Jacinto
    Universidade Federal do Piaui, Parnaíba, Brazil

Abstract

This paper reviews the current and most neurological (central nervous system, CNS) uses of the botulinum neurotoxin type A. The effect of these toxins at neuromuscular junction lends themselves to neurological diseases of muscle overactivity, particularly abnormalities of muscle control. There are seven serotypes of the toxin, each with a specific activity at the molecular level. Currently, serotypes A (in two preparations) and B are available for clinical purpose, and they have proved to be safe and effective for the treatment of dystonia, spasticity, headache, and other CNS disorders in which muscle hyperactivity gives rise to symptoms. Although initially thought to inhibit acetylcholine release only at the neuromuscular junction, botulinum toxins are now recognized to inhibit acetylcholine release at autonomic cholinergic nerve terminals, as well as peripheral release of neuro-transmitters involved in pain regulation. Its effects are transient and nondestructive, and largely limited to the area in which it is administered. These effects are also graded according to the dose, allowing individualized treatment of patients and disorders. It may also prove to be useful in the control of autonomic dysfunction and sialorrhea. In over 20 years of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

Keywords

botulinum toxin; neurology; rehabilitation

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Submitted: 2015-02-25 10:51:48
Published: 2015-09-24 13:10:04
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Copyright (c) 2015 Marco Orsini, Marco Antonio Araujo Leite, Tae Mo Chung, Wladimir Bocca, Jano Alves de Souza, Olivia Gameiro de Souza, Rayele Priscila Moreira, Victor Hugo Bastos, Silmar Teixeira, Acary Bulle Oliveira, Bruno da Silva Moraes, André Palma Matta, Luis Jorge Jacinto

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