Botulinum toxin (abbreviated as BTX or BoNT) is a neurotoxic protein produced by the bacteria Clostridium botulinum and related species. It is responsible for causing botulism disease, but it is also used commercially for medical and cosmetic purposes. It prevents the release of the neurotransmitter acetylcholine from the axonal endings at the neuromuscular junction, thus causing flaccid paralysis. Botulinum toxin can be ingested through contaminated food, colonization of the infant's gastrointestinal tract, or wound infection.
Botulinum toxin is often referred to as Botox, and it has been used to treat a wide variety of medical conditions, such as strabismus and focal dystonias, hemifacial spasms, various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond partially to medical treatment. Injection of Botulinum Toxin A into the foreskin or frenulum of the penis will have little effect on ejaculatory latency because Botulinum Toxin A exhibits no local anesthetic effect. Double-blind, placebo-controlled studies have been conducted to assess the safety and efficacy of botulinum toxin in upper limb spasticity after stroke or head injury. Percutaneous blockade of the celiac plexus with botulinum toxin a did not help the pain of chronic pancreatitis.
Endoscopic injection of botulinum toxin in patients with recurrent acute pancreatitis due to pancreatic sphincter of Oddi dysfunction has also been studied. The U. S. and Canada have further refined the use of botulinum toxin as a therapeutic agent.
Safety, efficacy, dosage and long-term resistance development with botulinum toxin type B in cervical dystonia has been studied. Autonomous cardiovascular function and baroreflex sensitivity in patients with cervical dystonia undergoing treatment with botulinum toxin type A has also been studied. A comparison of botulinum toxin injections and topical nitroglycerin ointment for the treatment of chronic anal fissure has been conducted. Pilot studies have been conducted to assess the safety and efficacy of Myobloc (botulinum toxin type B) for the treatment of axillary hyperhidrosis. Research is underway to determine if botulinum toxin type B injections are useful in patients with neutralizing antibodies to type A.
To date, no significant long-term risks have been identified from botulinum toxin injections in excess of the placebo groups.
