Rinsho Shinkeigaku (Clinical Neurology)

Symposium 3

Molecular mechanism of botlinum toxin therapy for spasticity

Takashi Sakamoto, M.D.

Department of Neurology, National Center Hospital of Neurology and Psychiatry

Botulinum toxin acts on the neuromuscular injections to block the neural transmission, resulting in the relief of hypercontraction of the muscles injected. For the treatment of spasticity, larger muscles in the extremitires are the targets of injection. Accurate injections are necessary for the effective botulinum therapy, using electromyogrphy for the precise approach and ultrasonography for the precise detection of muscles in layer. Recent report showed botulinum toxin is delivered via synapse vesicles, which suggests the more acetylcholine release response to the more botulinum toxin. Concerning antibody formation, the less moleculer weighted botulinum toxin can be available for the more dosage to treat larger muscles. The diffusion into the muscles or vessels, nerves nearby should be carefully avoided. FDA warning revealed severe respiratory complications including dead cases during usual botulinum toxin therapy. A2, not A1, toxin has a unique character not being tranported through axon, which can supply more safer treatment.
Full Text of this Article in Japanese PDF (224K)

(CLINICA NEUROL, 52: 1270|1271, 2012)
key words: botulinum toxin, spasticity

(Received: 25-May-12)