scholarly journals Therapeutic use of botulinum toxin in pain treatment

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Raj Kumar
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Botulinum Toxin ◽  
Acetylcholine Release ◽  
Pain Treatment ◽  
Muscle Relaxation ◽  
Cholinergic Synapse ◽  
Systems Research ◽  
Release Of Acetylcholine ◽  
Myofascial Syndrome

Botulinum toxin is one of the most potent molecule known to mankind. A neurotoxin, with high affinity for cholinergic synapse, is effectively capable of inhibiting the release of acetylcholine. On the other hand, botulinum toxin is therapeutically used for several musculoskeletal disorders. Although most of the therapeutic effect of botulinum toxin is due to temporary skeletal muscle relaxation (mainly due to inhibition of the acetylcholine release), other effects on the nervous system are also investigated. One of the therapeutically investigated areas of the botulinum neurotoxin (BoNT) is the treatment of pain. At present, it is used for several chronic pain diseases, such as myofascial syndrome, headaches, arthritis, and neuropathic pain. Although the effect of botulinum toxin in pain is mainly due to its effect on cholinergic transmission in the somatic and autonomic nervous systems, research suggests that botulinum toxin can also provide benefits related to effects on cholinergic control of cholinergic nociceptive and antinociceptive systems. Furthermore, evidence suggests that botulinum toxin can also affect central nervous system (CNS). In summary, botulinum toxin holds great potential for pain treatments. It may be also useful for the pain treatments where other methods are ineffective with no side effect(s). Further studies will establish the exact analgesic mechanisms, efficacy, and complication of botulinum toxin in chronic pain disorders, and to some extent acute pain disorders.

Botulinum Toxin Injections for Facial Rhytides

2011 ◽  
Author(s):  
Jill A. Foster ◽  
Matthew P. Ohr
Keyword(s):  
Nervous System ◽  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Botulinum Toxin Type B ◽  
Release Of Acetylcholine ◽  
To Come ◽  
Different Strains ◽  
The U.S

Once feared for its deadly properties, Botulinum toxin is now revered for its effectiveness as a treatment in minimally invasive facial rejuvenation. The injection of Botulinum toxin is the most frequently performed nonsurgical cosmetic procedure, with at least 4.8 million procedures in 2009. First approved by the U.S. Food and Drug Administration (FDA) in 1979 for the treatment of strabismus, Botulinum toxin was shown to be both safe and effective for use to decrease muscle function. Botulinum toxin’s cosmetic applications were first recognized when it was noted that facial rhytides improved in the areas of treatment with the toxin when it was used for noncosmetic applications in the late 1980s and early 1990s. FDA approval for cosmetic treatment of the glabellar furrows was announced in 2002, and off-label aesthetic indications have continued to evolve. Botulinum toxin is produced by the gram-positive, anaerobic Clostridium botulinum. The neurotoxin acts on the peripheral nervous system, where it inhibits release of acetylcholine from the presynaptic terminal at the neuromuscular junction. There are seven distinct antigenic Botulinum toxins (BTX-A, B, C, D, E, F, and G) produced by different strains of C. botulinum. The human nervous system is susceptible to only five of these serotypes (BTX-A, B, E, F, G), and types A and B are currently available for human injection. In the United States, there are four commercially available Botulinum toxin preparations: three types of Botulinum toxin type A, OnabotulinumtoxinA or Botox Cosmetic® (Allergan, Inc., Irvine, CA), IncobotulinumtoxinA or Xeomin (Merz, Frankfort Germany), and abobotulinumtoxinA or Dysport (Medicis, Scottsdale, AZ). There is one preparation of Botulinum toxin type B, RimabotulinumtoxinB or Myobloc® (Elan Pharmaceuticals, San Diego, CA). Other Botulinum toxin type A products are anticipated to come to the U.S. market in the next decade as well. Different formulations of Botulinum toxin type A are biochemically unique and are not necessarily equivalent in dosing. The Botox unit is three times as potent as the Dysport unit, but this conversion ratio does not take into consideration safety or antigenic potential. Practically speaking, a range of 2.5 to 3 to one has been recommended to make Dysport dosing approximate the effects of Botox.

scholarly journals Botulinum toxin in the treatment of neuralgia and neuropathic pain

2021 ◽  
Vol 11 (9) ◽  
pp. 310-314
Author(s):  
Katarzyna Mielniczek
Keyword(s):  
Neuropathic Pain ◽  
Botulinum Toxin ◽  
Pain Treatment ◽  
Therapeutic Effects ◽  
Local Skin ◽  
Pain Medications ◽  
Pubmed Database ◽  
Release Of Acetylcholine ◽  
Favorable Safety ◽  
Site Pain

Introduction: Botulinum toxin is one of the most powerful neurotoxins currently known, with high affinity to the cholinergic synapse, which sufficiently inhibits the release of acetylcholine. Its use has proved to be effective in the treatment of many diseases of the musculoskeletal system. Although most of the therapeutic effects of botulinum toxin are due to the temporary relaxation of skeletal muscles (caused by inhibition of acetylcholine release), research is ongoing into its effects on the nervous system. Purpose of the work: The aim of the study is to analyze the effectiveness of botulinum toxin in the treatment of neuralgia and neuropathic pain. Method: The relevant samples were accessed by means of an electronic search in the PubMed database. The analysis used reviews and meta-analyzes posted on the platform over the last 10 years. Conclusions: Botulinum toxin has great potential in the treatment of pain. It is multitasking due to its favorable safety profile and long-lasting relief from a single injection compared to other pain medications. The side effects caused by it were assessed to be mild to moderate and included a local skin reaction (swelling), injection site pain, muscle weakness, flu symptoms, nausea and vomiting. Keywords: botulinum toxin; neuropathic pain; pain treatment; neuralgia; BoNT / A

The mechanisms of action of Botulinum Toxin type A in nociceptive and neuropathic pathways in Cancer Pain.

2020 ◽  
Vol 27 ◽  
Author(s):  
Samuel Reyes-Long ◽  
Alfonso Alfaro-Rodríguez ◽  
Jose Luis Cortes-Altamirano ◽  
Eleazar LaraPadilla ◽  
Elizabeth Herrera-Maria ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Pain Treatment ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Mechanisms Of Action ◽  
Nociceptive Transmission ◽  
Calcitonin Gene ◽  
Release Of Acetylcholine ◽  
Cancer Experience

Background: Botulinum toxin type A (BoNT-A) is widely employed for cosmetic purposes and in the treatment of certain diseases such as strabismus, hemifacial spasm and focal dystonia among others. BoNT-A effect mainly acts at the muscular level by inhibiting the release of acetylcholine at presynaptic levels consequently blocking the action potential in the neuromuscular junction. Despite the great progress in approval and pharmaceutical usage, improvement in displacing BoNT-A to other pathologies has remained short. Patients under diagnosis of several types of cancer experience pain in a myriad of ways; it can be experienced as hyperalgesia or allodynia, and the severity of the pain depends, in some degree, on the place that the tumor is located. Pain relief in patients diagnosed with cancer is not always optimal, and as the disease progresses, transition to more aggressive drugs, like opioids is sometimes unavoidable. In recent years BoNT-A employment in cancer has been explored, as well as an antinociceptive drug; experiments in neuropathic, inflammatory and acute pain have been carried out in animal models and humans. Although its mechanism has not been fully cleared evidence has shown that BoNT-A inhibits the secretion of pain mediators (substance P, Glutamate, and calcitonin gene related protein) from the nerve endings and dorsal root ganglion, impacting directly on the nociceptive transmission through the anterolateral and trigeminothalamic systems. Aim: Collect available literature regarding molecular, physiological and neurobiological evidence of the BoNT-A in cancer patients suffering from acute, neuropathic and inflammatory pain in order to identify possible mechanisms of action in which the BoNT-A could impact positively in pain treatment. Conclusion: BoNT-A could be an important neo-adjuvant and coadjuvant in the treatment of several types of cancer, diminish pro-tumor activity and secondary pain.

scholarly journals Novel Therapeutic Approaches to the Treatment of Chronic Abdominal Visceral Pain

2006 ◽  
Vol 6 ◽  
pp. 472-490 ◽  
Author(s):  
Franca Patrizi ◽  
Steven D. Freedman ◽  
Alvaro Pascual-Leone ◽  
Felipe Fregni
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Visceral Pain ◽  
Pain Treatment ◽  
Therapeutic Option ◽  
Therapeutic Options ◽  
Central Nervous System Stimulation ◽  
Chronic Pain Treatment ◽  
Novel Therapeutic

Chronic abdominal visceral pain (CAVP) has a significant clinical impact and represents one of the most frequent and debilitating disorders in the general population. It also leads to a significant economic burden due to workdays lost, reduced productivity, and long-term use of medications with their associated side effects. Despite the availability of several therapeutic options, the management of patients with CAVP is often inadequate, resulting in frustration for both patients and physicians. This may in part be explained by the lack of understanding of the mechanisms underlying chronic pain; in contrast with acute pain in which the pathophysiology is relatively well known and has several satisfactory therapeutic options. Recently, the development of tools for brain investigation, such as functional magnetic resonance imaging, has provided new insights on the pathophysiology of chronic pain. These new data have shown that plastic changes in the central and peripheral nervous system might play an important role in the maintenance of chronic pain. Therefore, approaches aimed at the modulation of the nervous system, rather than the ones interfering with the inflammatory pathways, may be more effective for chronic pain treatment. We propose that noninvasive central nervous system stimulation, with transcranial magnetic stimulation (TMS), might be a novel therapeutic option for CAVP. This paper will present an overview of the pathophysiology and the available therapies for CAVP, focusing on the recent advances in the treatment of this pathology.

scholarly journals The Use of Botulinum Toxin in the Treatment of Trigeminal Neuralgia (Fifth Cranial Nerve)

2018 ◽  
Vol 20 (3) ◽  
pp. 43-50
Author(s):  
Rita María Marín Naranjo MQC, MSc
Keyword(s):  
Botulinum Toxin ◽  
Trigeminal Neuralgia ◽  
Muscle Relaxation ◽  
Oral Medications ◽  
Sporulation Process ◽  
Orofacial Region ◽  
Release Of Acetylcholine ◽  
Unbearable Pain ◽  
Subtype A ◽  
Natural Way

The Trigeminal Neuralgia (TN) is described as  neuropathic pain at the orofacial level, characterized by unbearable pain that can last from a few seconds to several minutes. The different treatments used for these patients are to numb the nerve, surgical, pharmacological, and the administration at extra and intraoral level of botulinum toxin, which is a neurotoxin produced in cultures of the bacterium Clostridium botulinum in a natural way; in the sporulation process are 7 subtypes being the subtype A the most used in neurological problems. The botulinum toxin acts as a neuromuscular blocker, by inhibiting the release of acetylcholine at the synaptic space, which is an important neurotransmitter to produce local muscle relaxation, and the patients report reductions in the frequency and intensity of pain with minimal side effects. The injection of botulinum toxin produces an effective pain reduction of neuropathic origin in the hyperalgesic tissue and is used as adjuvant therapy when oral medications do not give adequate control of pain. Over time it is expected to reduce the drugs as the patient tells that the pain has decreased or is being controlled. Patients are indicated the variation of time in which they can obtain relief of their pain. In patients with uncontrolled pain of the trigeminal nerve, the toxin is placed extraoral in the orofacial region with high effectiveness, but there is a lack of studies on the administration in the intraoral submucosal.

scholarly journals Effectiveness, safety and tolerability of botulinum toxin in focal hyperhidrosis and dynamic facial wrinkles

2019 ◽  
Vol 5 (1) ◽  
pp. 52
Author(s):  
K. Gopalakrishnan
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Muscle Relaxation ◽  
Botulinum Toxin Type A ◽  
Complete Response ◽  
Botulinum Toxin Type ◽  
Palmar Hyperhidrosis ◽  
Palmar Surface ◽  
Release Of Acetylcholine ◽  
Focal Hyperhidrosis

<p class="abstract"><strong>Background:</strong> Botulinum toxin is a potent neurotoxin that inhibits the release of acetylcholine at the neuromuscular junction thereby causing localized muscle relaxation which smoothen the overlying skin and reduces dynamic facial wrinkles. Also clinical studies suggest that intra dermal injections of botulinum toxin are effective in the treatment of palmar hyperhidrosis by blocking the excessive sympathetic cholinergic sudomotor nerve traffic to the palmar surface of the hands.</p><p class="abstract"><strong>Methods:</strong> We treated twenty patients with palmar hyperhidrosis and fifteen patients with dynamic facial wrinkles with intra dermal botulinum toxin type A.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among patients treated, complete response was seen in 90% of patients with hyperhidrosis and 70% for patients with facial wrinkles. The relapse of symptoms was highly variable among patients and the average relapse was seen at 14 weeks for both the indications. No major side effects noted.</p><p class="abstract"><strong>Conclusions:</strong> Botox is an effective and highly tolerable treatment for both hyperhidrosis and facial wrinkles.</p>

scholarly journals Case of iatrogenic botulism after botulinotherapy in clinical practice

2018 ◽  
Vol 90 (11) ◽  
pp. 102-104
Author(s):  
R A Ibatullin ◽  
R V Magjanov
Keyword(s):  
Botulinum Toxin ◽  
Muscle Relaxation ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Respiratory Arrest ◽  
Good Safety Profile ◽  
Release Of Acetylcholine ◽  
Swallowing Difficulty ◽  
Motor Nerves

Injections of botulinum toxin are widely used in different medical fields, namely neurology, urology, stomatology, cosmetology, gastroenterology etc. Preparations of botulinum toxin type A (BTA) prevent the release of acetylcholine at the endings of motor nerves leading to the long-term muscle relaxation. It has been acknowledged that treatment with BTA has very good safety profile and tolerability. Extremely rare but severe complication of botulinotherapy (BT) is a condition, which is associated with generalized muscle Weakness, swallowing difficulty, respiratory arrest, and may lead to the lethal outcomes in the solitary cases. Such disorders, which present like botulism, are known as botulism-like syndrome and iatrogenic botulism. We report a clinical case of such complication in the paper. The probability of the development of such rare but severe complications necessitates certain awareness and vigilance among clinicians performing BT.

scholarly journals Intranasal Administration for Pain: Oxytocin and Other Polypeptides

Pharmaceutics ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1088
Author(s):  
Vimala N. Bharadwaj ◽  
Alexander Z. Tzabazis ◽  
Michael Klukinov ◽  
Neil A. Manering ◽  
David C. Yeomans
Keyword(s):  
Chronic Pain ◽  
Nervous System ◽  
Pain Treatment ◽  
Peripheral Circulation ◽  
Nervous Systems ◽  
Analgesic Effects ◽  
Non Invasive ◽  
Central Nervous Systems ◽  
Chronic Pain Treatment ◽  
Plastic Changes

Pain, particularly chronic pain, remains one of the most debilitating and difficult-to-treat conditions in medicine. Chronic pain is difficult to treat, in part because it is associated with plastic changes in the peripheral and central nervous systems. Polypeptides are linear organic polymers that are highly selective molecules for neurotransmitter and other nervous system receptors sites, including those associated with pain and analgesia, and so have tremendous potential in pain therapeutics. However, delivery of polypeptides to the nervous system is largely limited due to rapid degradation within the peripheral circulation as well as the blood–brain barrier. One strategy that has been shown to be successful in nervous system deposition of polypeptides is intranasal (IN) delivery. In this narrative review, we discuss the delivery of polypeptides to the peripheral and central nervous systems following IN administration. We briefly discuss the mechanism of delivery via the nasal–cerebral pathway. We review recent studies that demonstrate that polypeptides such as oxytocin, delivered IN, not only reach key pain-modulating regions in the nervous system but, in doing so, evoke significant analgesic effects. IN administration of polypeptides has tremendous potential to provide a non-invasive, rapid and effective method of delivery to the nervous system for chronic pain treatment and management.

Severe Drooling and Treatment With Botulinum Toxin

2012 ◽  
Vol 21 (1) ◽  
pp. 15-21
Author(s):  
Merete Bakke ◽  
Allan Bardow ◽  
Eigild Møller
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Health Risk ◽  
Flow Rate ◽  
Clinical Evidence ◽  
Acetylcholine Release ◽  
Psychosocial Problems ◽  
Rate Reduction ◽  
Local Inhibition ◽  
Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

Yoga as an Effective Mind--Body Therapy in Chronic-Pain Treatment

2007 ◽  
Author(s):  
Malinda Breda ◽  
Richard Gevirtz ◽  
Melanie A. Greenberg ◽  
James L. Spira
Keyword(s):  
Chronic Pain ◽  
Pain Treatment ◽  
Body Therapy ◽  
Chronic Pain Treatment
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