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Treatment of Focal Muscle Overactivity Using Botulinum Toxin Injections

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Spasticity and Muscle Stiffness

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Abstract

Botulinum toxin, a neurotoxin produced by the bacteria Clostridium botulinum, has been used in the management of neurologic disorders. There are currently four formulations of toxin available for use in the United States: onabotulinumtoxinA (Botox®), abobotulinumtoxinA (Dysport®), incobotulinumtoxinA (Xeomin®), and rimabotulinumtoxinB (Myobloc®). This chapter describes the mechanism of action, pharmacology, guidelines for use, and techniques for administration of botulinum toxin in the management of adult upper and lower limb muscle overactivity in the context of spasticity. Additionally, it discusses the importance of goal attainment scales and optimization of the clinical response. The clinician must remember that botulinum toxin has only been shown to be efficacious in the symptomatic control of muscle overactivity, without a proven role in disease modification. Rehabilitation therapy, in addition to the administration of botulinum toxin, is necessary to improve functional outcomes.

Each muscle has its own peculiar purpose, and it obeys the decree of the composite sense.

– Avicenna, Canon of Medicine, 1025.

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Author information

Authors and Affiliations

  1. Department of Neurology, Division of Neuromuscular Medicine, NYU Grossman School of Medicine, New York, NY, USA

    Elina Zakin

  2. Department of Neurology, Division of Neuromuscular Medicine, Oregon Health and Science University, New York, NY, USA

    Yaowaree Leavell

  3. Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    David M. Simpson

Authors
  1. Elina Zakin
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  2. Yaowaree Leavell
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  3. David M. Simpson
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Corresponding author

Correspondence to Elina Zakin .

Editor information

Editors and Affiliations

  1. Departments of Physical Medicine and Rehabilitation and Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Preeti Raghavan

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Zakin, E., Leavell, Y., Simpson, D.M. (2022). Treatment of Focal Muscle Overactivity Using Botulinum Toxin Injections. In: Raghavan, P. (eds) Spasticity and Muscle Stiffness. Springer, Cham. https://doi.org/10.1007/978-3-030-96900-4_12

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