Currently, there are a lot of neurological diseases in which there is excessive muscle spasticity. Such pathologies are very difficult to correct due to the lack of effective treatment.
However, a real breakthrough in this area was the emergence of the possibility of using a substance such as botulinum toxin. What kind of drug is it, in which cases can it be used, and in which it is impossible, and also in what dosage is it prescribed and what is the form of release? All of this will be discussed below.
The concept of substance
Botulinum toxin is a substance secreted from the bacterium Clostridium botulinum and has the ability to block the transmission of impulses between the nervous and muscle tissue.
Botulinum toxin type A is used in neurology. It has the most pronounced properties and most effectively eliminates the spasm of various muscle groups.
Release form and description
Available in the form of a white powder, odorless, from which, immediately before the procedure, it is necessary to prepare a solution for injection.
The powder is packaged in 100 and 500 units in sterile glass bottles.
Mechanism of action
The mechanism of action is associated with an obstacle to the release of acetylcholine, without which the process of conducting a nerve impulse is impossible. Due to this, tension disappears in the muscles and they relax.
All this allows you to have a wide field of application of botulinum toxin in neurological practice. Indeed, many diseases in this area are associated with an increased tone of certain muscle groups.
Indications for use
Botulinum toxin in neurology has a wide list of various pathologies that it is able to correct. These include:
- Chronic headaches and migraines.
- Torticollis, which is caused by muscle spasm.
- Increased tonus of the eye muscles, as a result of which a person involuntarily often blinks or squints hard.
- Hemispasm of the face, in which the muscles of one side of the face are in tension, which is noticeable even with the naked eye.
- Muscle spasm around the mouth or chin (oro-mandibular dystonia).
- A spasm of the masticatory muscles (trismus) is often manifested by the inability to open or close the mouth.
- In neurology, botulinum toxin is also used to treat disorders in the passage of saliva and uncontrolled salivation.
- Muscle tension in the forearm or hand.
- Muscle tension of the extremities as a consequence of a stroke or traumatic brain injury.
- Trigeminal inflammation.
- Spur pain in the heel.
Contraindications
Despite a large list of indications, treatment with botulinum toxin in neurology is not always possible. The fact is that there are a number of conditions in which it is unacceptable to use this substance, namely:
- Hypersensitivity to botulinum toxin, which manifests itself in the form of an allergy.
- Infectious diseases in the acute phase.
- Genetic disturbance of the blood coagulation process (hemophilia).
Adverse reactions
Like any other drug, botulinum toxin in neurology can sometimes have a negative effect on the human body. However, the list of adverse reactions in this drug is small. The most common side effect of botulinum toxin in neurology is the appearance of pain at the injection site, which disappears after a short period of time. It is extremely rare, but still there is the occurrence of an allergic reaction in the form of edema, itching and rash.
However, it is worth noting that most side effects depend on the injection site. For example, in the treatment of bladder incontinence, constipation very often occurs, and in the treatment of headaches - insomnia.
Dosage
The required amount of the drug can only be determined by the attending physician. The dosage is individual for each patient and depends on his gender, weight, age, as well as the diagnosis. Therefore, it is impossible to say what dosages of botulinum toxin are in neurology.
Overdose
The main thing you need to know is that the maximum amount of the drug administered should not exceed 350 units at a time. Otherwise, an overdose may occur, the symptoms of which will be:
- general weakness;
- drooping eyelids;
- disruption of the speech apparatus.
The worst consequence of an overdose is paralysis of the muscles of the respiratory system. In this case, the patient must urgently be hospitalized, intubated and placed on a ventilator until the person comes to his senses and cannot breathe on his own.
special instructions
Botulinum toxin should only be administered strictly according to indications, in a specific dosage and in a specific area of the muscles on the body. Therefore, the introduction of the drug should be done only by a specially trained doctor. He must have permission of a certain sample from the pharmaceutical company that produces this drug.
The injection procedure can only be carried out within the walls of a medical institution. The calculation of the dose and the determination of the injection site are carried out by the doctor individually for each patient. In the event that the procedure is performed by an unqualified person, damage to nerves and blood vessels is possible, which can lead to serious consequences.
You should take into account the fact that there is a possibility of the formation of antibodies to the botulinum toxin in the blood of the body, which makes the further use of the drug impossible. Most often this happens with the introduction of large doses - 250 or more units. This phenomenon is not very common and occurs only in 4 percent of people after repeated administration of the drug in high concentrations at intervals of less than two months.
When using botulinum toxin in order to reduce the blinking frequency, there is a risk of damage to the epithelial tissue of the eye and damage to the cornea with the formation of ulcers on it. To avoid this, it is necessary to first assess the sensitivity of the cornea of the eyes, do not inject into the lower eyelid, otherwise this can lead to its inversion.
In addition to the advantages, this method of treating certain neurological diseases also has disadvantages, the main of which is a short-term effect. Moreover, the duration of the drug decreases each time. For example, after the first use, the substance acts from eight months to a year, while after the second - already about six months, and after the third - about 4 months. Of course, these dates are very individual. In practice, there are cases when, even after the fourth application, the effect lasts about eight months, and it happens that after the first time the drug is effective for only six months. It is impossible to predict the time of action of botulinum toxin, it all depends on the individual characteristics of the body.
Patient Reviews
Botulinum toxin has been used in neurology for a long time, and many people managed to feel its therapeutic effect on themselves. One of the advantages of this treatment is its low invasiveness, as well as the ability to return home within a few hours after the injection.
The most commonly used botulinum toxin in neurology is after a stroke. It often happens that when a brain lesion occurs, a severe muscle spasm of some limbs occurs and a person loses the ability to move normally. Botulinum therapy in such cases is an excellent way to treat such conditions that have no analogues.
The main drawback of the patients is the high cost of treatment, as well as the not very long-lasting effect of the drug.
Drug cost
It should be noted immediately that botulinum toxin is not sold at any pharmacy. And even more so it is not a prescription drug.
Only certain suppliers are licensed and entitled to do so. Only certain medical organizations may purchase.
If we are talking about paid specialized clinics, the price varies from 100 to 450 rubles per unit of botulinum toxin.
On the Internet, you can find offers on the free purchase of a substance. All this is the activity of scammers. You should not buy medicine from them to avoid unforeseen consequences that can lead to death.
Conclusion
The use of botulinum toxin in neurology is a unique method of ridding a huge number of patients of problems that often significantly impair their quality of life. Therefore, for some people, this method of treatment is a real salvation. However, due to its high cost, for many it remains unattainable.