The American Academy of Neurology (AAN) has issued new guidelines on the use of botox for several neurological conditions.
The recommendations serve as an update of the 2008 guideline to help physicians manage a number of neurological conditions, including four new disorders, which were not included in the previous version.
The new guidelines were presented at the AAN's 68th annual meeting.
For the first time, the AAN guidelines now include botox recommendations for migraine management.
Aside from headache or migraine, the other three neurological disorders that were added to the new version include blepharospasm, cervical dystonia and adult spasticity.
Blepharospasm
Blepharospasm is characterized by abnormal and uncontrollable muscle contractions. An example of its possible consequence is the inability to close the eyelids.
In the new guideline, AAN recommends three types of botox injections, which may be used as treatment options for blepharospasm. All these toxins are said to have similar rates of efficacy and can persist to be effective even in the long term.
Cervical Dystonia
Cervical dystonia (CD) is characterized by the involuntary contractions of the muscles in the neck and upper shoulders. This causes a person to have abnormal postures and movements that are particularly apparent in the head, shoulders and neck.
AAN recommends two types of botox injections for each level of of CD. The authors add that botox type A is the first line of treatment for CD. While there are differences in the evidence levels across brands and botox types, all formulations are said to be approved and widely used.
Adult Spasticity
Spasticity is the heightened, involuntary and velocity-driven muscle tone that may cause resistance to movement.
AAN recommends four types of botox injections for upper limb spasticity in adults, while for lower limb spasticity, the group recommends two.
AAN stresses that although botox can decrease spasticity, its impact on a functional level varies. This signifies that effects may be patient-specific.
It must be remembered that there are significant differences in each formulation of botox. Therefore, the new guidelines provided by AAN were derived from the evaluation of each single botox class for each specific indication. The 2008 guideline did otherwise.
"Efficacy of BoNT (botox) is for symptomatic control, as there is no evidence for disease modification," the authors write.
A Look At Botox
Botox or botulinum toxin (BTX) is most popular for its cosmetic application of ridding wrinkles and giving a younger-looking skin. What most people do not know is that botox has been used for many years as treatment for numerous chronic medical conditions, specifically those that involve pain and involuntary muscle movement problems.
The neurotoxic protein, which is derived from the bacterium Clostridium botulinum, works by inducing temporary paralysis of muscles, thus halting contractions in patients with involuntary muscle movements.
Botox prevents nerve endings from letting out a chemical that initiates muscle movement and pain signaling.
The new guidelines were published in the journal Neurology on April 18.
