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2 results

  • Chapter 22 - Cosmetic Uses of Botulinum Neurotoxins for the Upper Face

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 188-196

  • Summary

    Botulinum neurotoxin (BoNT) injections are the most commonly performed cosmetic procedure in the USA. Rhytids, commonly known as wrinkles, develop over time from repeated pleating and contraction of underlying skeletal muscle along with decreased elasticity and thickness of the overlying skin. Typically, rhytids appear perpendicular to the direction of muscular contraction.

    BoNT prevents skeletal muscle contraction by inhibiting acetylcholine release from the neuromuscular junction, thereby relaxing the relevant muscles. BoNT can soften the appearance of rhytids and reduce further formation. This chapter discusses the use of BoNT specifically for the treatment of rhytids of the upper face including the glabella, forehead, peri-ocular region and nose. Many of these treatments are considered off-label but are known to be safe and effective.

  • 9 - Spasticity and botulinum toxin

    • By Michael P. Barnes, Professor of Neurological Rehabilitation Walkergate Park International Centre for Neurorehabilitation and Neuropsychiatry, Newcastle upon Tyne, UK, Elizabeth C. Davis, Consultant in Rehabilitation Medicine Walkergate Park International Centre for Neurorehabilitation and Neuropsychiatry, Newcastle upon Tyne, UK
  • Edited by Michael P. Barnes, University of Newcastle upon Tyne, Garth R. Johnson, University of Newcastle upon Tyne
  • Book:
    Upper Motor Neurone Syndrome and Spasticity
    Published online:
    22 August 2009
    Print publication:
    24 April 2008, pp 165-180

  • Summary

    Botulinum toxin (BoNT) is the most potent neurotoxin known, and its clinical effects have been recognized since the end of 19th century. There are seven immunologically distinct serotypes of botulinum toxin; there are two types in routine clinical use - BoNT type A (BoNT-A) and BoNT type B (BoNT-B). Most of the large-scale studies on botulinum toxin have been related to upper and lower limb spasticity. The usefulness of BoNT in the management of spasticity secondary to a variety of clinical conditions is increasing. It is now well accepted for the management of movement disorders, particularly dystonia. There is an increasing evidence base for the use as a management tool in spasticity. The products now have a licence for use in focal spasticity. Dysport is indicated for focal spasticity specifically including arm symptoms associated with focal spasticity in conjunction with physiotherapy.