Therapeutic use of botulinum toxins: background and history

Clin J Pain. Nov-Dec 2002;18(6 Suppl):S119-24. doi: 10.1097/00002508-200211001-00002.


The seven botulinum neurotoxin serotypes share less than 50% sequence homology and are immunologically distinct. The neurotoxins inhibit release of the neurotransmitter acetylcholine from the axon terminals of motor neurons, preganglionic sympathetic and parasympathetic neurons, and postganglionic parasympathetic nerves by a multi-step mechanism that differs slightly, but significantly, for each serotype. The inhibition is long lasting but temporary. The resulting muscle paralysis has provided the basis for therapeutic use of botulinum toxin types A and B in a variety of focal dystonias. The safety of the botulinum toxins, when administered focally, has permitted their widespread use in a number of other painful conditions.

Publication types

  • Review

MeSH terms

  • Acetylcholine / antagonists & inhibitors
  • Acetylcholine / metabolism
  • Botulinum Toxins / administration & dosage
  • Botulinum Toxins / classification
  • Botulinum Toxins / metabolism
  • Botulinum Toxins / therapeutic use*
  • Botulinum Toxins, Type A / therapeutic use
  • Humans
  • Nervous System Diseases / drug therapy*
  • Pain / drug therapy*


  • Botulinum Toxins
  • Botulinum Toxins, Type A
  • Acetylcholine