Botulinum Toxin is a very potent poison produced by a bacterium, Clostridium botulinum. This toxin causes muscle paralysis and is responsible for causing Botulism, a potentially fatal disease, although the doses for its application as a medical therapy do not present any danger to humans.
Beyond cosmetic surgery
The aesthetic use of this substance is the best known among today’s society. However, this perception is far from reality. Ophthalmologists were the first to use Botulinum Toxin to improve strabismus. Later, neurologists began to use it to treat certain movement disorders such as dystonia in arms and legs and, later, in patients with spasticity. Aesthetic medicine was the third to arrive.
The reality is that Botulinum Toxin is a medical therapy and its use in aesthetic medicine is much less frequent than in neurology. On the one hand because very little quantity is used, since in each Neurology session between 100 and 200 units of the substance are used as opposed to the 50 units used in Plastic Surgery. On the other hand, because the greatest volume of Botulinum Toxin treatments are used to treat neurological diseases.
Individualizing the treatment
Although there are protocols for action, treatment must be individualized for each patient. Not all spasticity is the same, not all increased muscle tone is the same and not every migraine manifests itself in the same way. It is therefore the neurologist’s responsibility to develop a personalized treatment.
In a Botulinum Toxin treatment, the union between the nerve and the muscle is “broken” producing a weakness in the latter. So when it is applied in the right muscle, the specific pathology improves a lot.
Normally Botulinum Toxin is used in a repetitive treatment for a certain period of time, until the muscle re-establishes its normal function, or until there is no possibility of reinnervation.
Direct application or by EMG
When applying Botulinum Toxin, the role of the specialist is very important. Above all, he/she must know the muscles and the function of the muscle to be injected. Muscles can be superficial or deep. Superficial muscles are under the skin and can be palpated, so that the application of the toxin is direct.
On the other hand, in deep muscles (in the back of the thigh, leg or in some muscles of the forearm) or in people with a thick adipose panniculus, it is necessary to use an electromyograph to detect the contraction of the muscle to which we want to inject the toxin. Thanks to this technique we can inject the toxin in the right muscle, so that the effectiveness of the treatment is higher.
In this field, the most significant advance, apart from the fact that more and more pathologies are becoming known in which botulinum toxin can be used effectively, would be the monitoring of the injection of the toxin by means of ultrasound control for these deep muscles.