Chemodenervation Clinic, Botulinum Toxin Clinic in UAE

Chemodenervation is a term regularly used to define the use of Botulinum Toxin in treating several neurological conditions. Botulinum Toxin is a product formed by bacteria Clostridium botulinum. In the purified form it is used for cosmetic and neurological conditions. There are several neurological diseases where botulinum toxin is very helpful in making the quality of life better for the patients. Physicians may use Chemodenervation to reduce symptoms of cerebral palsy, spasmodic torticollis, dystonia and other movement disorders.

Botulinum toxin blocks the release of neurotransmitters at the junction of nerve and muscle which causes the relaxation of the muscles. This neurotoxin is inserted straight into the muscle tissue to weaken extreme activity in specific focal areas and it is injected in perfect amount to avoid any paralysis.

Botulinum toxin is injected into the muscle using a very fine needle. I tell my patients that it is like “mosquito bite” to the most, but it is well tolerated. In many cases, the injections are performed under EMG (electromyography) guidance. This allows the neurologist to make sure that the injection is being administered to the affected muscles.

The maximum effects are most apparent within almost 5 to 7 days after treatment. The effect of botulinum toxin injection typically lasts up to three to four months. Some patients might need reinjections more often than others dependent on the severity of the muscle tightness.

The answer is “No”. Since past 30 years Botox has been evolved for treating various diseases based on the detailed scientific investigation, research, trials and publications. The uses of botulinum toxin has expanded recently. We have recently published several papers for use of botulinum toxin in Parkinson’s disease tremor, Essential tremor and pain conditions like post herpetic neuralgia, trigeminal neuralgia, restless leg syndrome etc. Dr. Shivam Mittal and his colleagues in USA have done the first and only large study in world on Parkinson’s disease tremor.

It is treatment of choice for dystonia condition. Please see the section of dystonia to get more information. It is used for various neurological diseases which includes movement disorders conditions such as Cervical dystonia, Writer’s cramp, Post-Stroke or post-traumatic spasticity (muscle tightness), chronic migraine headaches, Hemifacial Spasms, Blepharospasm, Tremor conditions (Parkinson’s tremor, Essential tremor, Dystonic tremor, tremor in Multiple Sclerosis) and Restless leg syndrome. It is also useful in pain conditions such as Trigeminal neuralgia, Post herpetic neuralgia, post surgical/radiation pain conditions. It is also very helpful in patients who have drooling of saliva (sialorhea), excessive sweating of palms and axilla (hyperhidrosis), spasmodic dysphonia, vocal cord tremor and rare conditions like First Bite Syndrome.

The medication is directly injected into the area of the body where benefit is intended for. E.g., in to cervical muscles in cervical dystonia and ocular muscles for blepharospasm. For selected areas of the body, and particularly when injecting muscles that are difficult or impossible to palpate, guidance using an electromyography (EMG) may be necessary. For instance, when injecting the deep muscles of the jaw, neck, or vocal cords, an EMG-guided injection may improve precision since these muscles cannot be readily palpated. An EMG measures and records muscle activity and may help the physician locate overactive muscles.

I have seen patients receiving botulinum toxin for 30years without any long term side effects. Many times, with few injections for dystonia, spasticity and pain, the dosage of botulinum toxin can be reduced or the duration between the injections can be prolonged.