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Related Concept Videos

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

Centrally Acting Muscle Relaxants: Therapeutic Uses

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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
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Classification of Skeletal Muscle Relaxants01:28

Classification of Skeletal Muscle Relaxants

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Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
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Peripherally and Centrally Acting Muscle Relaxants: A Comparison01:09

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Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
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Spasmolytic Agents: Chemical Classification01:29

Spasmolytic Agents: Chemical Classification

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Spasmolytic agents are drugs used to alleviate muscle spasms and spasticity. They can be categorized into different chemical groups based on their mechanisms of action. Centrally acting spasmolytics primarily affect the spinal cord, while others directly target skeletal muscle cells.
A major class of centrally acting spasmolytics is the α2-agonist, such as tizanidine. These drugs bind to α2-adrenoceptors, inhibiting the release of the excitatory neurotransmitter glutamate. They also...
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Related Experiment Video

Updated: Nov 29, 2025

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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Botulinum toxin type A therapy for hemifacial spasm.

Gonçalo S Duarte1,2, Filipe B Rodrigues1,2, Mafalda Castelão1,2

  • 1Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.

The Cochrane Database of Systematic Reviews
|November 19, 2020
PubMed
Summary
This summary is machine-generated.

No randomized trials were found comparing botulinum toxin type A (BtA) to placebo for hemifacial spasm (HFS). Observational data suggest BtA is effective and safe for HFS treatment.

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Area of Science:

  • Neurology
  • Ophthalmology

Background:

  • Hemifacial spasm (HFS) involves involuntary unilateral facial muscle contractions.
  • It is a chronic condition with rare spontaneous recovery.
  • Current treatments include microvascular decompression and botulinum toxin type A (BtA) injections.

Purpose of the Study:

  • To compare the efficacy, safety, and tolerability of BtA versus placebo in individuals with HFS.
  • To update previous Cochrane Review findings on HFS treatments.

Main Methods:

  • Searched CENTRAL, MEDLINE, Embase, and other sources in July 2020.
  • Included double-blind, parallel, randomized, placebo-controlled trials (RCTs) of BtA versus placebo in adults with HFS.
  • Assessed records independently, extracted data, and evaluated risk of bias; planned meta-analyses.

Main Results:

  • No parallel-group randomized controlled trials comparing BtA and placebo for HFS were identified.
  • The review could not draw conclusions on the efficacy and safety of BtA due to the lack of RCTs.

Conclusions:

  • No randomized trials were found to evaluate the efficacy and safety of botulinum toxin type A for hemifacial spasm.
  • Observational data indicate a favorable safety profile and symptom improvement with BtA.
  • Future research should focus on long-term effects, quality of life, and comparative effectiveness of different BtA formulations.