PT  - JOURNAL ARTICLE
AU  - J Jankovic
TI  - Botulinum toxin in clinical practice
AID  - 10.1136/jnnp.2003.034702
DP  - 2004 Jul 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 951--957
VI  - 75
IP  - 7
4099  - http://jnnp.bmj.com/content/75/7/951.short
4100  - http://jnnp.bmj.com/content/75/7/951.full
SO  - J Neurol Neurosurg Psychiatry2004 Jul 01; 75
AB  - Botulinum toxin, the most potent biological toxin, has become a powerful therapeutic tool for a growing number of clinical applications. This review draws attention to new findings about the mechanism of action of botulinum toxin and briefly reviews some of its most frequent uses, focusing on evidence based data. Double blind, placebo controlled studies, as well as open label clinical trials, provide evidence that, when appropriate targets and doses are selected, botulinum toxin temporarily ameliorates disorders associated with excessive muscle contraction or autonomic dysfunction. When injected not more often than every three months, the risk of blocking antibodies is slight. Long term experience with this agent suggests that it is an effective and safe treatment not only for approved indications but also for an increasing number of off-label indications.