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16 - Other clinical neurological uses of botulinum toxin

Published online by Cambridge University Press:  02 December 2009

By
Michael P. Barnes
Edited by
Anthony B. Ward  and
Michael P. Barnes
Michael P. Barnes
Affiliation:
Walkergate Park, International Centre for Neurorehabilitation and Neuropsychiatry, Newcastle upon Tyne, UK
Anthony B. Ward
Affiliation:
University Hospital of North Staffordshire
Michael P. Barnes
Affiliation:
Hunters Moor Regional Neurological Rehabilitation Centre
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Summary

Introduction

This chapter will highlight some of the less common but nevertheless helpful uses of botulinum toxin for a variety of neurological conditions. The list of potential uses of botulinum toxin is growing each year and this chapter does not attempt to offer a completely comprehensive guide to every case report in every potential neurological condition. This chapter discusses the reasonably established use in the following conditions:

  • Tics

  • Myoclonus

  • Stiff person syndrome

  • Parkinson's disease

  • Tremor

  • Limb dystonia including occupational cramps

Each section will give a brief overview of the condition itself and then give some thoughts with regard to the place of botulinum toxin in the treatment of the condition. None of these conditions yet constitute a licensed indication for botulinum toxin type A or type B. Indeed the conditions and indications are so rare that it is unlikely that definitive trials will be undertaken in order to satisfy the licensing regulations. However, the lack of a license indication can still mean that botulinum toxin may be a useful addition to our therapeutic armoury in these conditions, which are often difficult to ameliorate.

Tics

Background

A tic is a sudden rapid recurrent non-rhythmic stereotyped motor movement or vocalization. Tourette's syndrome is characterized by both multiple motor and vocal tics. Tics are extremely common in childhood and some studies indicate a prevalence of up to a quarter of all children being affected at some point during their childhood.

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Clinical Uses of Botulinum Toxins , pp. 349 - 374
Publisher: Cambridge University Press
Print publication year: 2007

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