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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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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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Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
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Botulinum toxin for motor disorders.

Delaram Safarpour1, Bahman Jabbari2

  • 1Department of Neurology, Oregon Health & Science University, Portland, OR, United States.

Handbook of Clinical Neurology
|August 24, 2023
PubMed
Summary
This summary is machine-generated.

Botulinum neurotoxins, derived from Clostridium botulinum, offer muscle relaxation for motor disorders. This chapter explores their use in treating dystonia, tremor, and spasticity with injection techniques.

Keywords:
Botulinum neurotoxinBotulinum toxinDystoniaMotor systemSpasticityTremor

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Area of Science:

  • Neuroscience
  • Toxicology
  • Medical treatment

Background:

  • Botulinum neurotoxins are potent biological toxins produced by Clostridium botulinum bacteria.
  • Intramuscular injection of these toxins induces dose-dependent muscle relaxation.
  • This effect is therapeutically valuable for managing various motor and movement disorders.

Approach:

  • This chapter reviews the application of botulinum toxin therapy.
  • Focuses on three prevalent conditions: dystonia, tremor, and spasticity.
  • Includes a literature summary and recommended injection techniques.

Key Points:

  • Botulinum toxin treatment is effective for dystonia, tremor, and spasticity.
  • Understanding injection techniques is crucial for optimal therapeutic outcomes.
  • The chapter synthesizes current knowledge and practical recommendations.

Conclusions:

  • Botulinum neurotoxins are versatile therapeutic agents for motor system dysfunctions.
  • Evidence supports their utility in treating dystonia, tremor, and spasticity.
  • This work provides a comprehensive overview for clinicians and researchers.