After direct superior rectus muscle injection of BtA in rabbit eyes, we examined the ultrasructural changes of the muscles from 1 day to 8 weeks after injection. The most profound changes seen at electron microxcopic levels after BtA injedtion were early vacuolization of the sarcoplasmic structure, extensive damage of myofibril, degeneration of the postjunctional fold and widening of the synaptic cleft. Myofiber changes were reversible with no apparent long-term consequence. However, most of the degenerations of myoneuronal junction were still present in 8 weeks post-injedtion. Comparing myotoxic effects according to rabbit age, the botulinum toxin seems to make more severe histologic damage in the fibers of the two-month old than six-month old or older. AchE activity of injection group is mildly decrease in number of positive fibers rather than control group, which was not statistically significant in the quantitative analysis. In conclusion the early vacuolization and degeneration of the sarcoplasmic structure, and degeneration of the postjunctional folds after toxin injection in the muscles are most likely due to a direct myotoxic effect of BtA.
Botulinum Toxins* ; Botulinum Toxins, Type A ; Muscles ; Myofibrils

No abstract available.
Botulinum Toxins* ; Botulinum Toxins, Type A* ; Hyperhidrosis*

Background: Resting tremor is a prominent cardinal motor symptom of Parkinson’s disease (PD). In some cases, the tremor may be refractory to dopaminergic and anticholinergic treatment. Multiple studies were previously done to evaluate the effectiveness of Botulinum Neurotoxin A (BoNT/A) with essential tremors and dystonia, but data regarding its use on tremors of PD is still lacking. Objective: This meta-analytic study aims to determine the effectiveness of BoNT/A in treating tremors of patients with PD. Data Sources: Data Sources: Researches were searched at PubMed, ScienceDirect and EBSCO Host. Review Methods: Articles on the effect of BoNT/A on PD hand tremors were searched. Studies and data pertaining to non-PD tremors like essential tremors excluded in the analysis due to difference in pathophysiology. Standardized mean difference was used as the effect measure and was computed with Review Manager version 5.4 software. Results: Three open label studies were used for final analysis in this study. Studies included are those pertaining to tremors due to PD. Pooled estimates showed a significant change in decreasing tremor score after BoNT/A injection. Conclusion Botulinum Toxin A injections can be used to manage PD tremors effectively.
Botulinum Toxins, Type A ; Tremor

We studied the safety and complication associated with treatment with botulinum A toxin chemodenervation. 70 eyes was entrolled and treated with botulinum A toxin chemodenervation. They were examed at 1 day, 1 week, 2 weeks, 1 month, 3 months and 6 months after the injection. Ptosis developed in 19 of 70 eyes(27.1%), but all of them recovered fully at 6 months after injection. A vertical deviation was noted in 19 eyes(27.1%), but all except one recovered fully at 6 months. Ptosis and vertical deviation developed more frequently in the group with the medial rectus muscle injection than with lateral rectus muscle injection. Subconjunctival he.morrhage and headache were also noted in 1 eye, respectively, but they disappeared at 4 weeks after the injection. Aggrevation of diplopia after injection was noted in 1 eye, which disappeared at 3 weeks after injection. Botulinum A toxin chemodenervation can be considered to be a safe method for the treatment of strabismus without the long-lasting serious complications.
Botulinum Toxins* ; Botulinum Toxins, Type A* ; Diplopia ; Headache ; Nerve Block ; Strabismus*

BACKGROUND:This study was designed to evaluate the efficacy of subcutaneous Botulinum toxin type A (BoNT-A) injection for treating chronic medial knee pain with osteoarthritis. METHODS:A randomized, double-blind, placebo-controlled clinical trial was conducted at a university hospital in Korea.The subjects suffering from chronic medial knee pain with osteoarthritis were randomly allocated to either the BoNT-A (treatment, n = 23) group or the normal saline (placebo, n = 27) group.Injections were given to 10 points per unilateral knee along the course of the saphenous nerve.A total of 90 units of BoNT-A (60 units at baseline and 30 units after 1 week) was given for treating unilateral knee pain and a total of 180 units of BoNT-A was given for treating bilateral knee pain.The placebo group received the same volume of normal saline. RESULTS:The Visual Analog Scale (VAS) pain score was significantly decreased in both the BoNT-A and normal saline groups 1, 4 and 12 weeks after injection.After adjusting for covariates, BoNT-A had a 0.788 times higher effect to decrease the VAS score than did normal saline, but the effect was marginally significant (P = 0.050). CONCLUSIONS:Subcutaneous injection along the course of the saphenous nerve significantly reduces chronic medial knee pain. The pain reduction effect of BoNT-A is higher than that of placebo, but the effect is marginally significant
Botulinum Toxins ; Botulinum Toxins, Type A ; Knee ; Osteoarthritis ; Stress, Psychological

BACKGROUND:This study was designed to evaluate the efficacy of subcutaneous Botulinum toxin type A (BoNT-A) injection for treating chronic medial knee pain with osteoarthritis. METHODS:A randomized, double-blind, placebo-controlled clinical trial was conducted at a university hospital in Korea.The subjects suffering from chronic medial knee pain with osteoarthritis were randomly allocated to either the BoNT-A (treatment, n = 23) group or the normal saline (placebo, n = 27) group.Injections were given to 10 points per unilateral knee along the course of the saphenous nerve.A total of 90 units of BoNT-A (60 units at baseline and 30 units after 1 week) was given for treating unilateral knee pain and a total of 180 units of BoNT-A was given for treating bilateral knee pain.The placebo group received the same volume of normal saline. RESULTS:The Visual Analog Scale (VAS) pain score was significantly decreased in both the BoNT-A and normal saline groups 1, 4 and 12 weeks after injection.After adjusting for covariates, BoNT-A had a 0.788 times higher effect to decrease the VAS score than did normal saline, but the effect was marginally significant (P = 0.050). CONCLUSIONS:Subcutaneous injection along the course of the saphenous nerve significantly reduces chronic medial knee pain. The pain reduction effect of BoNT-A is higher than that of placebo, but the effect is marginally significant
Botulinum Toxins ; Botulinum Toxins, Type A ; Knee ; Osteoarthritis ; Stress, Psychological

PURPOSE: To investigate the efficacy of botulinum toxin type A chemodenervation in various types of esotropia(ET). METHODS: Enrolled eleven esotropic patients treated with botulinum toxin type A and examined the amount of esotropic correction and success rate of less than 10 PD (prism diopter) of postinjection deviation at 5 months after injection. RESULTS: Among the eleven esotropic patients, there were 7 cases of infantile ET, 2 cases of partially accommodative ET and 2 cases of basic ET. The mean preinjection deviation was 30.5 +/- 7.3 PD. The amount of correction was 17.7 +/- 4.3 PD and correction rate of deviation was 57.5%. In 6 of 11 cases, the postinjection deviation was within 10 PD and therefore success rate was 54.5%. In 5 patients (45.5%), their ET was undercorrected. In patients with under 20 PD of preinjection deviation, success rate was 75% (3/4) and those with over 20PD, the rate was 42.9% (3/7). In partially accommodative ET, 2 (100%) of 2 cases were aligned within 10PD. CONCLUSIONS: In comitant ET, botulinum toxin chemodenervation shows high undercorrection rate. The effects of botulinum toxin type A chemodenervation were better for relatively small angle and in partially accommodative ET than nonaccommodative one. But further study with more cases is needed.
Botulinum Toxins* ; Botulinum Toxins, Type A* ; Esotropia* ; Humans ; Nerve Block

No abstract available.
Botulinum Toxins ; Botulinum Toxins, Type A ; Cicatrix ; Cleft Lip

No abstract available.
Botulinum Toxins, Type A* ; Muscles* ; Nerve Block*

PURPOSE: To compare the clinical efficacy, duration of effect, and safety of Dysport and Botox for patients with essential blepharospasm using functional disability scale. METHODS: Patients with a confirmed diagnosis of essential blepharospasm who had received Botox (Allergan, USA) from September 2006 to May 2007 were enrolled in this study. We switched from Botox to Dysport (Ipsen, UK) after the botulinum effect of previous injection had disappeared and compared the clinical efficacy of two drugs. We used a 2.5:1 Dysport:Botox conversion ratio. The clinical efficacy of the drugs treatment was evaluated using a functional disability scale. We compared the duration of the effect and the safety of the two drugs. RESULTS: The study included 48 patients (43 women, 5 men). There was no significant difference in mean functional disability scores or in any item of the functional disability scale. There was no significant difference in duration of effect between Botox (100.2+/-37.34 days) and Dysport (99.1+/-39.7days). There was also no significant difference in frequency of adverse reaction between Botox (13%) and Dysport (10%). CONCLUSIONS: When a dose conversion of 2.5:1 Dysport:Botox was used for essential blepharospasm patients, the two drugs displayed almost identical clinical efficacy, duration of effect, and safety.
Blepharospasm ; Botulinum Toxins, Type A ; Female ; Humans