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by Aaron S

Botulinum Toxin Injections—Medical

(Botulinum Toxin Type A; Botulinum Toxin Type B; Botox Injections)

Definition

Botulinum toxin is made from a type of bacteria. It is toxic to the nerves. An injection puts this toxin into muscle. There, it blocks the chemical signal from the nerves to muscles. This will decrease the muscle contraction.
Botulinum toxin is used for cosmetic and medical reasons. The injection process is often called botox injection, although any brand of the botulinum toxin may be used.

Reasons for Procedure

The injection is FDA-approved to treat:
  • Cervical dystonia—abnormal spasms of neck muscles
  • Blepharospasm—spasm of eyelid muscles
  • Strabismus—crossed eyes
  • Hyperhydrosis—excessive sweating
The injection has also been used to treat other conditions, such as:
  • Migraine headaches and tension headaches
  • Achalasia—spasm of esophageal muscles causing difficulties in swallowing
  • Spasmodic dysphonia
  • Muscle spasms due to cerebral palsy
  • Spasticity associated with multiple sclerosis
  • Spasticity in leg and arm muscles due to brain injury/stroke
  • Focal limb dystonias
  • Incontinence due to bladder problems
  • Anal sphincter disorders
  • Peripheral nerve pain
  • Temporomandibular disorder (jaw disorder)
Strabismus
Lazy eye
Copyright © Nucleus Medical Media, Inc.

What to Expect

Anesthesia

Most often, none is given. Some patients may prefer to have the area numbed for comfort. In this case, a topical anesthetic may be used.

Description of the Procedure

A thin needle will be used. The doctor will inject the toxin through the skin into the targeted muscle. You will often need several injections in a small area.

After Procedure

There is very little recovery needed, but remember to:
  • Remain upright for several hours
  • Avoid alcohol

How Long Will It Take?

The length will depend on the number of sites involved. It is often less than 20 minutes.

Will It Hurt?

You may have some minimal discomfort.

Post-procedure Care

Normal activities may be resumed after the procedure. For the best recovery, follow your doctor's instructions .
The toxin temporarily weakens targeted muscles. The treatment lasts up to four months. With repeated use, the effects may last longer.

Call Your Doctor

Contact your doctor if any of the following occurs:
  • Difficulty breathing
  • Difficulty swallowing
  • Difficulty speaking
  • Severe lower eyelid droop or obstructed vision
  • Excessive weakness around the injection site
  • Rash or any other sign of an allergic reaction
In case of an emergency, call for medical help right away.

RESOURCES

American Society for Dermatologic Surgery http://www.asds.net

American Society of Plastic Surgeons http://www.plasticsurgery.org

CANADIAN RESOURCES

Canadian Dermatology Association http://www.dermatology.ca

Health Canada http://www.hc-sc.gc.ca

References

Allergan Physician Production Information. Botox cosmetic (botulinum toxin type A). Published April 2008.

Ondo WG, Gollomp S, Galvez-Jimenez N. A pilot study of botulinum toxin A for headache in cervical dystonia. Headache . 2005;45(8):1073-1077.

Ward A, Roberts G, Warner J, et al. Cost-effectiveness of botulinum toxin type A in the treatment of post-stroke spasticity. J Rehabil Med . 2005;37(4):252-257.

11/4/2009 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : FDA gives update on botulinum toxin safety warnings. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm175013.htm . Updated August 3, 2009. Accessed November 4, 2009.

3/19/2010 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : FDA approves Botox to treat spasticity in flexor muscles of the elbow, wrist and fingers. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm203776.htm . Updated March 9, 2010. Accessed March 19, 2010.

5/17/2012 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis. JAMA. 2012;307(16):1736-1745.

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