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Guidelines for the therapeutic use of botulinum toxin in movement disorders

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Abstract

Since its introduction in the early '80s the use of botulinum toxin has improved the quality of life of the patients affected by movement disorders. Toxin's neuromuscular blocking action allows a symptomatic treatment of those clinical conditions characterised by excessive muscular activity. Although the dosages used are safe and the side-effects are reversible, a correct use of botulinum toxin depends on the knowledge of its clinical pharmacology and of the anatomy of the body segments to be injected. In addition, the treatment of more complex conditions, i.e. laringeal dystonia, imposes an inter-disciplinary approach and specialised injection techniques.

In this review, the Italian Study Group on Movement Disorders presents the consensus guidelines for the therapeutic use of botulinum toxin in movement disorders. The main toxin types, their use and administration modalities, and the training guidelines will be presented.

Sommario

Dalla sua introduzione nei primi anni '80, l'uso della tossina botulina ha prodotto un sensibile miglioramento della qualità della vita dei pazienti affetti da disordini del movimento. La sua azione bloccante la trasmissione neuromuscolare ha consentito il trattamento sintomatico di quelle condizioni cliniche caratterizzate da eccessiva attività muscolare. Nonostante la relativa sicurezza dei dosaggi impiegati e l'assenza di effetti collaterali irreversibili l'adeguato uso della tossina botulinica nei disordini del movimento dipende da conoscenze specifiche di farmacologia clinica e di anatomia normale funzionale dei distretti da infiltrare. Inoltre, per il trattamento di patologie più rare o complesse, come ad esempio la disfonia spasmodica, si rendono necessari un approccio interdisciplinare e speciali tecniche di somministrazione.

In questo articolo vengono presentate le principali indicazioni alla terapia con tossina botulinica dei disordini del movimento redatte dal Gruppo di Studio per i Disordini del Movimento della S. I. N. Sono inoltre esposti i principali tipi di tossina disponibili sul mercato italiano, le modalità di uso e somministrazione nonché le nozioni di addestramento per il personale medico che intenda attuare tali terapie.

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Authors and Affiliations

  1. Italian Study Group for Movement Disorders, Italian Society of Neurology, Italy

    Berardelli A., Abbruzzese G., Bertolasi L., Cantarella G., Carella F., Currà A., Grandis D. De, DeFazio G., Galardi G., Girlanda P., Livrea P., Modugno N., Priori A., Ruoppolo G., Vacca L. & Manfredi M.

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  1. Berardelli A.
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  2. Abbruzzese G.
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  3. Bertolasi L.
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Berardelli, A., Abbruzzese, G., Bertolasi, L. et al. Guidelines for the therapeutic use of botulinum toxin in movement disorders. Ital J Neuro Sci 18, 261–269 (1997). https://doi.org/10.1007/BF02083302

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