By W. H. Jost
The enormously winning historical past of botulinum toxin and its most probably destiny has infrequently an identical. at the beginning, it used to be utilized in strabismus, blepharospasm and hemifacial spasm, later additionally in focal dystonia and spasticity and it's been proven to successfully deal with wrinkles, hyperhidrosis and numerous resulting symptoms. by means of treating signs or issues linked to ache, its analgesic impact used to be first spotted. The efficacy and purposes for this facet impact have on account that been investigated and a few types explaining the mode of motion were offered. even if, no matter if we all know that botulinum toxin definitely is helping in yes ache syndromes, there's nonetheless a lot paintings to do to spot the key ones, outline the optimal dose and the popular web site of injection. Indicating present positions and kindling the transforming into curiosity during this striking healing agent this e-book provides a well timed evaluation on ache administration with botulinum toxin.
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Extra info for Botulinum Toxin in Painful Diseases (Pain and Headache)
3) and additionally some disturbance of the Z-bands structure (fig. 4). Myofascial Pain Syndrome 27 Fig. 4. Histopathology of human trigger point: disturbance of Z-bands’ structure. Electron microscopy. (Courtesy of Prof. Dr. Müller-Höcker, Munich, Germany). Electrodiagnostic Criteria Needle Electromyography There is no doubt that in every active trigger point region spontaneous electrical activity can be recorded. Subsequent electromyographic studies in rabbits and humans have confirmed the presence of spontaneous low-voltage motor endplate activity (endplate noise or endplate spikes, respectively) that is a highly characteristic finding in myofascial trigger points but not pathognomonic (fig.
The correct localization of the muscle was obtained by fluoroscopy showing intramyofascial spread of contrast solution (Isovue 180-M, 2 ml). Up to 3 treatments were given at least 4 weeks apart to prior injection if persistent muscle spasm were present and patients’ pain continued. Measurements were obtained at 4-week intervals for up to 6 months. More than 50% reduction in the level of palpable muscle spasm and patients’ own assessment of effectiveness were achieved in 63% of the cervicothoracic and 43% of the low back pain group 6 months after treatment.
G. grinding and clenching of the teeth). Pain on pressure mainly exists in the deep part in the insertion area of the muscle on the zygomatic bone and typically tends to radiate into the maxilla and mandible, as well as the lateral teeth. The lower area of the muscle on the angle of the mandible is less often affected, and then frequently in connection with significant masseter hypertrophy. As a result, both extraoral and intraoral injection is possible. Freund et al. [13, 14] prefer the extraoral injection of doses of 5 U Botox distributed over the entire muscle area (total dose: 25 to 50 MU Botox).