A neurologist is a doctor of medicine specialized in diagnosis and treatment of a human nervous system diseases. While the reasons to visit a neurologist are numerous, they are most often related to neurological conditions such as epilepsy, migraine, consciousness disturbances combined with pass-outs, or head injuries.
Also, the patients who complain about memory or concentration loss and those with increased muscle fatigue, distorted hearing, vision or smell should be taken care by a neurologist.
Neurological disorders often cause difficulties in everyday functioning, which is why the effective treatment of ailments is so important – where botulinum toxin injections are employed as well.
BOTULINUM TOXIN INJECTIONS
A modern method of treatment allowing to reduce the amount of taken medications, which is at the same time related to a decrease in adverse drug reactions to oral pharmacotherapy and contributes to improvement in the quality of the patient’s life. The botulinum toxin injection consists in administering a small amount of the drug subcutaneously, intramuscally or to salivary glands. The treatment is intended to inhibit secretion of the nerve endings neurotransmitter (acetylocholine) in the area of neuromuscular junctions leading to relaxation and loosening of the treated muscles. Despite that, the toxin inhibits saliva production, blocks conductivity in the autonomous system through sensory fibres and reduces most substances which act on the pain receptors (nociceptors), therefore alleviating the pain, for example in the torticollis, postictal spasticity, chronic migraine headaches or neuropathic pain. The initial therapeutic effect appears after several days and intensifies about 2 weeks after the medicine is administered, while the medicinal effect is maintained for 3-4 months from the procedure. The best medicinal effect can be achieved in persons who undergo the procedure cyclically.
INDICATIONS FOR THE PROCEDURE
- Chronic migraine
- Chronic neuropathic pain (including the trigeminal neuralgia)
- Salivation (among others in the Parkinson’s disease, after a stroke, etc.)
- Spasticity of upper- and lower-limbs muscles: after a stroke or injury, multiple sclerosis, cerebral palsy, etc.
- Cervical dystonia, including head and neck trembling
- Facial dystonia, including bruxism
- Hemifacial spasm
- Writer's cramp
CONTRAINDICATIONS FOR THE PROCEDURE
The only definite contraindications for treatment with botulinum toxin are myasthenia gravis and local infection in the spots of the planned injections. Relative contraindications are pregnancy, breastfeeding, some relevant bleeding disorders, severe generalized infections - and thus it is recommended to inform the medical personnel about all taken anticoagulants, any fresh infections or other conditions which may impact the immunity system of the patient.
Stanisław Szlufik MD