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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

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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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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.
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Related Experiment Video

Updated: Jul 29, 2025

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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Trigeminal neuralgia: IncobotulinumtoxinA (Xeomin), can it decrease the pharmacological intervention? (A case

Meghdad Hosseini1, Farhad Asarzadegan1, Erfan Shafiee1

  • 1Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Caspian Journal of Internal Medicine
|May 24, 2023
PubMed
Summary

Incobotulinumtoxin A effectively reduced pain frequency, severity, and duration in trigeminal neuralgia patients. This new treatment offers a promising alternative for managing this disabling facial pain syndrome.

Keywords:
Iran.NeuralgiaPainTrigeminal

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Area of Science:

  • Neurology
  • Pain Management
  • Pharmacology

Background:

  • Trigeminal neuralgia is a severe facial pain syndrome.
  • Incobotulinumtoxin A is an emerging therapeutic strategy.
  • This study investigates its efficacy in managing trigeminal neuralgia.

Observation:

  • Three female patients (39-49 years) with trigeminal neuralgia were treated.
  • Conventional pharmacological treatments showed limited improvement.
  • Incobotulinumtoxin A (Xeomin, 50 units) was administered once.

Findings:

  • Incobotulinumtoxin A significantly decreased pain frequency, severity, and duration.
  • Treatment resulted in minimal side-effects.
  • Visual analogue scale assessed pain severity.

Implications:

  • Incobotulinumtoxin A presents a viable treatment option for trigeminal neuralgia.
  • Further research on its long-term effects and potential complications is warranted.
  • This offers hope for patients with refractory facial pain.