Abstract
Botulinum toxin is produced by Clostridium botulini bacteria. It has been increasingly used as a boon in medical practice for chemodenervation in conditions like skeletal muscle spasticity, glandular hypersecretion, neuropathic pain and smooth muscle hyperactivity. The action of Botulinum neurotoxin (BoNT) is by blocking the neurotransmission at the cholinergic nerve endings, by inhibiting the docking and fusion of Acetyl Choline (Ach) vesicles for exocytosis into the synaptic area.Botulinum toxin has been used for management of neurological disorders with great patient satisfaction and appreciation. The effect of botulinum toxin wears off in 3-6 months and may require another dose. Frequent dosing may lead to production of antibodies against BoNT with consequent irresponsiveness to therapy in a few cases. Scrupulous use of botulinum toxin in the hands of experts may help a long way in giving much needed relief and respite to neurological patients and increase their quality of life. Its use in cosmetic dermatology in reducing wrinkles, by relaxing the facial muscles is very popular
Highlights
Botulinum toxin is produced by the bacteria Clostridium botulinum
[4] Since FDA has approved the use of Botox for various procedures such as Cervical dystonia in 2000, Glabellar lines in 2002, Axillary hyperhidrosis in 2004, Chronic migraines and upper lip spasticity in 2010, Urinary incontinence in 2011 and Corresponding author: Nusrat Aziz Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Kingdom of Saudi Arabia
Headache, bruising, swelling, pain at the site of injection, droopy angle of mouth, eye dryness, unequal level of eyebrows, diplopia and ptosis are some of the side effects of Botulinum neurotoxin (BoNT) [18] on face for cosmetic use, blepharospasm and strabismus
Summary
Botulinum toxin is produced by the bacteria Clostridium botulinum. This is a potent biological toxin and can produce fatal disease. The effect of clostridium botulinum was described by German scientist Justinus Kerner from the outbreaks caused due to bad sausages between1817-1822 and gave an idea of its scope for therapeutic use. These outbreaks typically showed symptoms like blurry vision, drooping eyelids, slurred speech, difficulty swallowing, vomiting, and severe muscle weakness. Scott and Edward Schantz used botulinum toxin in early 1970s as medical treatment for correction of strabismus by relaxing the muscles [3] They used injection of type A botulinum toxin which was later approved by Food and Drug Administration in 1989. It blocks the docking and fusion process of acetyl choline containing vesicles and the release of neurotransmitter acetyl choline by exocytosis at the neuromuscular junction or the gland is blocked as is shown Fig below
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