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Year : 2011  |  Volume : 1  |  Issue : 2  |  Page : 126-133

Adverse effects of botulinum neurotoxin A in spasticity management

1 VA Central Iowa Health Care System, Des Moines, IA, USA
2 Orthopedic and Neurological Rehabilitation, 1101 S. Capital of Texas Hwy, Austin, TX, USA

Correspondence Address:
Tapan N Joshi
VA Central Iowa Healthcare System, 3600, 30th Street, Des Moines, IA - 50310
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-0738.84202

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Over the last few decades, Botulinum neurotoxin has evolved from a well-publicized public health threat of food-borne illness, due to contaminated foods, to a widely used therapeutic measure. Botulinum neurotoxin A is one of the seven distinct neurotoxins produced by Clostridium botulinum. The mechanism of action is to block the transmission of overactive nerve impulses to the targeted muscle by selectively preventing the release of the neurotransmitter acetylcholine at the neuromuscular junction. Its efficacy is evident in the treatment of both adults and children with spasticity of various causes. It is considered a safe therapy with most of the adverse events being self-limited and transient. Serious side effects like unwanted muscle weakness and suboptimal response to therapy mainly due to antibody formation are uncommon, but possible. This article gives an in-depth review of the possible adverse effects of botulinum toxin A and their pathogenesis for spasticity management. Physicians should carefully perform a detailed clinical assessment of every patient individually, for a benefit-risk profile, while making treatment decisions, to prevent such adverse events.

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