Therapeutic Uses of Botulinum Toxin

von: Grant Cooper

Humana Press, 2007

ISBN: 9781597452472 , 238 Seiten

Format: PDF, OL

Kopierschutz: Wasserzeichen

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Therapeutic Uses of Botulinum Toxin


 

Preface

6

Acknowledgments

7

Contents

8

Contributors

9

History and Mechanism of Action

11

INTRODUCTION

11

MEDICAL COMMUNITY GETS INVOLVED

11

DISCOVERY OF THE BACTERIUM

13

BOTULINUM TOXIN STUDIED

13

NORMAL NEUROMUSCULAR JUNCTION

14

BOTULINUM TOXIN MECHANISM OF ACTION

14

REFERENCES

15

Spasticity

16

INTRODUCTION

16

PATHOPHYSIOLOGY

16

RISK FACTORS

18

HISTORY/CLINICAL EXAMINATION

18

DIAGNOSTIC EVALUATION

19

DIFFERENTIAL DIAGNOSIS

19

TREATMENT APPROACH

20

BTX Injection

23

CONCLUSION

26

REFERENCES

26

Radiation Fibrosis Syndrome

28

INTRODUCTION

28

PATHOPHYSIOLOGY

28

RISK FACTORS

33

HISTORY

34

CLINICAL EXAMINATION

36

DIAGNOSTIC EVALUATION

36

DIFFERENTIAL DIAGNOSIS

37

TREATMENT APPROACH

38

CONCLUSION

45

REFERENCES

45

Low Back Pain

48

INTRODUCTION

48

RISK FACTORS

48

Occupational Factors

48

Patient-Related Factors

49

Anthropomorphic Factors

49

Psychosocial Factors

49

ETIOLOGY OF BACK PAIN

49

Primary Spinal Causes of LBP

49

Secondary Causes of LBP

53

Referred Causes for Back Pain

54

DIAGNOSTIC APPROACH

54

History

54

Physical Exam

56

Imaging

61

Treatment

62

CONCLUSION

67

REFERENCES

67

Piriformis Syndrome

69

INTRODUCTION

69

HISTORY OF PS

69

EPIDEMIOLOGY

70

DIAGNOSIS

71

DOES PS EXIST?

73

PATHOGENETIC MECHANISM

74

NONOPERATIVE MANAGEMENT

74

OUR METHOD OF INJECTION

76

CLINICAL EXPERIENCE

79

REFERENCES

81

Plantar Fasciitis

83

DEFINITION AND ANATOMY

83

BIOMECHANICAL FACTORS AND PATHOPHYSIOLOGY

83

EPIDEMIOLOGY AND RISK FACTORS

84

DIFFERENTIAL DIAGNOSIS

85

HISTORY AND PHYSICAL EXAMINATION

85

DIAGNOSIS

85

TREATMENT

86

BOTULINUM TOXIN TYPE A INJECTION PROCEDURE (FIGS. 9–11)

92

ACKNOWLEDGMENTS

97

REFERENCES

97

Headache

98

INTRODUCTION

98

BACKGROUND

98

EPIDEMIOLOGY/SYMPTOMATOLOGY Migraine Headache

99

Tension-Type Headache

100

PATHOPHYSIOLOGY Migraine Headache

101

Tension Headache

102

CLINICAL DIAGNOSIS History

102

Physical Examination

103

Diagnostic Evaluation

104

TREATMENT APPROACH Migraine

104

Tension-Type Headaches

106

How BoNT Fits In

106

RISKS AND HAZARDS

110

Eyelid Ptosis (Blepharoptosis)

110

Brow Ptosis

111

Diplopia

111

Minor Sequelae

111

POST-INJECTION MANAGEMENT

111

FREQUENCY OF INJECTIONS

112

SUCCESS WITH BoNT

112

CONCLUSIONS

112

REFERENCES

113

SUGGESTED FURTHER READING

115

Spasmodic Dysphonia

116

INTRODUCTION

116

BACKGROUND

116

EPIDEMIOLOGY/SYMPTOMATOLOGY

117

PATHOPHYSIOLOGY

118

CLINICAL DIAGNOSIS

119

ANATOMICAL LANDMARKS

120

TREATMENT APPROACH BTX: Rationale for Use

121

Technical Aspects

121

Risks and Hazards

125

Frequency of Administration

126

Success With BTX

126

CONCLUSIONS

127

REFERENCES

127

Sialorrhea and Frey’s Syndrome

129

INTRODUCTION

129

SIALORRHEA

129

Epidemiology/Symptomatology

131

Clinical Diagnosis

132

Treatment Approach

133

Conclusion

136

GUSTATORY SWEATING

136

Epidemiology and Symptomatology

137

Clinical Diagnosis

137

Treatment Approach

138

Conclusion

139

REFERENCES

140

Cosmetic Applications

142

INTRODUCTION

142

PHARMACOLOGY

142

DILUTION AND DOSING

142

CONTRAINDICATIONS

143

ADVERSE EVENTS

143

PATIENT EVALUATION

143

GENERAL INJECTION GUIDELINES

143

CLINICAL APPLICATIONS Glabellar Frown Lines

144

Horizontal Forehead Lines

147

Crow’s Feet

150

“Bunny” Lines

152

Perioral Lines

153

Mental Crease and Dimpled Chin

153

Mouth Frown

154

Platysmal Bands

154

Horizontal Neck Lines

154

SUMMARY

155

REFERENCES

155

Hyperhydrosis

157

INTRODUCTION

157

DIAGNOSIS

159

TREATMENT ALGORITHM

160

BTX INJECTION PROCEDURE

162

Axilla

162

Palms

165

Soles

167

CONCLUSION

168

REFERENCES

168

SUGGESTED FURTHER READING

170

Urological Applications

171

INTRODUCTION

171

DIAGNOSIS AND EVALUATION OF LUT DYSFUNCTION

172

History and Physical Examination

173

Validated Questionnaires and Voiding Diary

174

The Pad Test

174

Routine Urological Assessment

174

Urodynamics

175

Cystourethroscopy

175

CLINICAL APPLICATION OF BTX IN THE TREATMENT OF LUT DYSFUNCTION Detrusor – Sphincter Dyssynergia and Related Disorders

175

Neurogenic and Idiopathic Detrusor Overactivity

178

Sensory Disorders/Interstitial Cystitis/Pelvic Pain Disorders

181

Benign Prostatic Hypertrophy

183

BTX-B in the Treatment of Urological Disorders

184

CLINICAL ISSUES RELATED TO BTX INJECTION Injection Duration

186

Treatment Onset

187

Repeat Injection

187

Side Effects

188

PROTOCOL FOR BTX INJECTION

189

Injection Dose

189

Injection Volume

190

Injection Distribution

190

Bladder Injection Technique

192

Urethral Injection Technique

192

CONCLUSION

194

REFERENCES

194

Gastrointestinal Applications

198

INTRODUCTION

198

BTX-A FOR THE TREATMENT OF GASTROPARESIS

198

TREATMENT OF ACHALASIA WITH BTX-A

200

BTX-A FOR THE TREATMENT OF ANAL FISSURE

204

CONCLUSION

207

REFERENCES

208

Blepharospasm

211

INTRODUCTION

211

CLINICAL FINDINGS

211

TERMINOLOGY

211

DIFFERENTIAL DIAGNOSIS

212

PATHOGENESIS

212

TREATMENT

213

Botulinum Toxin Type A

213

Oral Medications

215

Surgery

220

CONCLUSION

221

REFERENCES

221

Economics, Immunity, and Future Directions

224

INTRODUCTION

224

ECONOMIC CONSIDERATIONS

224

THE DEVELOPING ROLE OF BTX

226

CONCLUSION

227

REFERENCES

228

Index

230