botox injections in leg muscle after stroke side effects

These central effects may be the consequence of hematogenic spread, a retrograde neural transport of BoNT to the central nervous system (CNS) or an indirect action due to denervation and changes of afferent input resulting in the plastic reorganization of the CNS.

Although it is widely accepted that its therapeutic effects are restricted to the peripheral nervous system, additional actions at distant sites and central effects are also presumed. It cleaves SNARE (soluble N-ethylmaleimide-sensitive-factor attachment receptor) complex proteins and blocks acetylcholine release at the neuromuscular junction, thus resulting in a transient denervation and weakening of muscle contractions responsible for excessive involuntary movements. It does this by binding and internalization by the presynaptic cholinergic neuron. BoNT reduces muscle hyperactivity via its action at the neuromuscular junction. Importantly, BoNT-related central effects and consecutive modulation and/or reorganization of the brain may not solely be considered “side-effects” but rather an additional therapeutic impact responsible for a number of clinical observations that cannot be explained by merely peripheral actions.īotulinum neurotoxin type A (BoNT) is used in a variety of clinical conditions such as spastic or dystonic disorders. Collectively, these data strongly point to indirect mechanisms via changes to sensory afferents that may be primarily responsible for the marked plastic effects of BoNT on the central nervous system. In this review, we report and discuss the current evidence for BoNT’s central effects based on clinical observations, neurophysiological investigations and neuroimaging studies in humans. However, recent evidence suggests that BoNT’s pharmacological properties may not only be limited to local muscular denervation at the injection site but may also include additional central effects. BoNT is known to primarily act at the neuromuscular junction resulting in a biochemical denervation of the treated muscle.

For more than three decades, Botulinum neurotoxin (BoNT) has been used to treat a variety of clinical conditions such as spastic or dystonic disorders by inducing a temporary paralysis of the injected muscle as the desired clinical effect.

Botox injections in leg muscle after stroke side effects