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Clinical value of botulinum toxin in neurological indications


Dr Anthony B. Ward, North Staffordshire Rehabilitation Centre, Haywood Hospital, High Lane, Burslem, Stoke-on-Trent, ST6 7AG, UK (tel.: +44 (0)1782 556226; fax: +44 (0)1782 556165; e-mail:


Botulinum toxin type-A (BoNT-A) prevents the release of acetylcholine at cholinergic junctions, thereby causing temporary muscle weakness lasting 3–4 months. It is now widely used to treat a broad range of clinical disorders characterized by muscle hyperactivity. BoNT-A has proved effective in the management of several neurological conditions and, in particular, in the management of movement disorders (e.g. blepharospasm, cervical dystonia, laryngeal dystonia, limb dystonia, hemifacial spasm, focal tics, tremor and other hyperkinetic disorders). As a treatment of spasticity, BoNT-A can improve mobility and dexterity as well as preventing the development of distressing and costly secondary complications. In cerebral palsy, BoNT-A is of value, being able to delay or even avoid surgery until motion patterns have become established.