RT Book, Section
A1 Raj, Prithvi P.
A1 Sangha, Sara D.
A2 Warfield, Carol A.
A2 Bajwa, Zahid H.
SR Print(0)
ID 3421175
T1 Chapter 70. Use of Botulinum Toxin in Pain Management
T2 Principles & Practice of Pain Medicine, 2e
YR 2004
FD 2004
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071443494
LK accessanesthesiology.mhmedical.com/content.aspx?aid=3421175
RD 2024/04/19
AB Botulinum  toxins  are  potent  neurotoxins  produced  by  the  bacteria  Clostridium  botulinum.  The  most  widely  studied  effect  of  botulinum  toxins  is  at  the  neuromuscular  junction  where  they  block  the  release  of  acetylcholine  preventing  muscle  contraction  and  causing  local  flaccid  paralysis  (rather  than  rigid,  or  tetanic,  paralysis  caused  by  a  related  clostridial  protein,  tetanus  toxin).  This  results  in  a  temporary  (months)  chemodenervation  and  the  loss  or  reduction  in  activity  in  the  target  organ  (muscle,  sweat  gland,  or  sphincter)  with  minimal  risk  of  systemic  adverse  effects.  However,  botulinum  toxins  work  not  only  at  the  neuromuscular  junction  but  also  alter  the  sensory  input,  producing  secondary  changes  at  the  central  level.  The  broadening  clinical  role  of  botulinum  toxins  depends  on  the  multiple  direct  and  indirect  effects  that  the  toxin  exerts  in  both  the  peripheral  nervous  system  and  in  the  central  nervous  system  (CNS).