March 19, 2004
The Arizona Republic
QUESTION: I've heard there are uses for botox beyond keeping faces from wrinkling. What kind of medical conditions lend themselves to botox use?
ANSWER: As you're aware, the most common use of botox is using it in anti-aging to freeze facial muscles under the skin so that it won't wrinkle. This use has become so popular that women now attend botox parties in each other's homes and get injections in this social setting.
The other medical uses of botox aren't as glamorous or fun as the one you know about, but they can be quite beneficial.
People with diseases that cause muscle spasms and tremors can find relief when botox is used. These conditions include muscle spasms from multiple sclerosis and cerebral palsy or neurological conditions, such as cervical dystonia. Eyelid and facial spasms also respond to the drug. Other uses include migraine headaches and leg stiffness/weakness in stroke patients.
Botox is a drug made from botulinum toxin type A, the bacteria associated with food poisoning. Given in small doses, botox blocks release of acetylcholine, a neurotransmitter that activates muscle contractions. This is how painful muscle spasms and tremors are significantly reduced or eliminated. These injections weaken muscle activity enough to reduce a spasm but not enough to cause paralysis.
The U.S. Food and Drug Administration approved botulinum toxin for the treatment of blepharospasm. In 2000, the FDA approved the use of both botox and Myobloc (type B) for treatment of cervical dystonia. Botox is also administered "off label" with FDA approval for many uses. A physician trained to administer this treatment should be the only one to do so.
For instance, injected with a hypodermic needle into the forehead if it is determined to be a trigger point in the treatment of migraines, the drug begins to give the patient relief. One injection is not enough, so patients receiving botox must keep getting many small injections during one session. Results last from weeks to months before additional injections are needed.
Also, patients receiving botox for muscle spasms and tremors usually require physical or occupational therapy to maintain muscle mobility and strength.
Some patients may experience temporary weakness and discomfort in the treated area. Others may develop a resistance to botulinum toxin type A but may respond to type B.
So, you see, there are a variety of useful medical treatments using
botox that go more than skin-deep.
Dr. Jason Reinhart is a neurologist on the medical staffs of Sun Health
Boswell and Del E. Webb Memorial hospitals.
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