Botulinum toxin in neurological clinical practice

Botulinum toxin is produced by Clostridium botulini bacteria. It has been increasingly used as a boon in medical practice for chemodenervation in conditions like skeletal muscle spasticity, glandular hypersecretion, neuropathic pain and smooth muscle hyperactivity.
The action of Botulinum neurotoxin (BoNT) is by blocking the neurotransmission at the cholinergic nerve endings, by inhibiting the docking and fusion of Acetyl Choline (Ach) vesicles for exocytosis into the synaptic area.Botulinum toxin has been used for management of neurological disorders with great patient satisfaction and appreciation. The effect of botulinum toxin wears off in 3-6 months and may require another dose. Frequent dosing may lead to production of antibodies against BoNT with consequent irresponsiveness to therapy in a few cases.
Scrupulous use of botulinum toxin in the hands of experts may help a long way in giving much needed relief and respite to neurological patients and increase their quality of life. Its use in cosmetic dermatology in reducing wrinkles, by relaxing the facial muscles is very popular.