RT Book, Section A1 Malik, Atif B. A1 Khojasteh, Soorena A1 Bajwa, Zahid H. A2 Bajwa, Zahid H. A2 Wootton, R. Joshua A2 Warfield, Carol A. SR Print(0) ID 1131938361 T1 Use of Botulinum Toxins in Pain Syndromes T2 Principles and Practice of Pain Medicine, 3e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071766838 LK neurology.mhmedical.com/content.aspx?aid=1131938361 RD 2024/03/29 AB Botulinum toxins (BTX) are potent neurotoxins produced by the bacterial spores of Clostridium botulinum. The major effect of BTX is at the neuromuscular junction, where they block the release of acetylcholine, preventing muscle contraction and causing dose-dependent weakness (rather than titanic weakness caused by tetanus toxin, a related clostridial protein). This blockade results in a temporary loss or reduction in activity in the target organ (muscle, sweat gland, and sphincter) with minimal risk of systemic adverse effects. However, BTX work not only work at the neuromuscular junction but also alter the sensory input, producing secondary changes at the central level. Clinical use of BTX depends on the multiple direct and indirect effects that the toxin exerts in the peripheral nervous system and the central nervous system (CNS).