TY - CHAP M1 - Book, Section TI - Chapter 70. Use of Botulinum Toxin in Pain Management A1 - Raj, Prithvi P. A1 - Sangha, Sara D. A2 - Warfield, Carol A. A2 - Bajwa, Zahid H. PY - 2004 T2 - Principles & Practice of Pain Medicine, 2e 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). SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=3421175 ER -