Botulinum toxin therapy: its use for neurological disorders of the autonomic nervous system

J Neurol. 2013 Mar;260(3):701-13. doi: 10.1007/s00415-012-6615-2. Epub 2012 Aug 10.

Abstract

Botulinum toxin (BoNT) has gained widespread use for the treatment of overactive muscles, overactive exocrine glands and, most recently, non-muscular pain conditions. Autonomic conditions treated with BoNT include achalasia, gastroparesis, sphincter of Oddi spasms, and unspecific esophageal spasms in gastroenterology and prostate disorders in urology. BoNT's use for autonomic conditions related to neurology includes various forms of bladder dysfunction (detrusor sphincter dyssynergia, idiopathic detrusor overactivity, neurogenic detrusor overactivity, urinary retention and bladder pain syndrome), pelvic floor disorders (pelvic floor spasms and anal fissures), hyperhidrosis (axillary, palmar, and plantar hyperhidrosis, diffuse sweating, Frey's syndrome) and hypersalivation (hypersalivation in Parkinsonian syndromes, motor neuron disease, neuroleptic use, and cerebral palsy). Hyperhidrosis, hypersalivation, some forms of bladder dysfunction and pelvic floor disorders can easily be treated by neurologists. Most bladder dysfunctions require cooperation with urology departments.

MeSH terms

  • Animals
  • Autonomic Nervous System Diseases / drug therapy*
  • Autonomic Nervous System Diseases / pathology*
  • Autonomic Nervous System Diseases / physiopathology
  • Botulinum Toxins / therapeutic use*
  • Female
  • Humans
  • Male
  • Nervous System Diseases / drug therapy
  • Nervous System Diseases / pathology
  • Nervous System Diseases / physiopathology
  • Neural Pathways / anatomy & histology
  • Neural Pathways / drug effects
  • Neural Pathways / physiology
  • Prostatic Diseases / drug therapy
  • Prostatic Diseases / pathology
  • Prostatic Diseases / physiopathology
  • Urinary Bladder Diseases / drug therapy
  • Urinary Bladder Diseases / pathology
  • Urinary Bladder Diseases / physiopathology

Substances

  • Botulinum Toxins