Zdravljenje z botulinom = Treatment with botulinus toxin
Pirtošek, Zvezdan, 1956-
In the last ten years, botulinus toxin has become the preferred treatment for many disorders characterised by muscular hyperactivity. It is a first-line treatment for hemifacial spasm and focal ...dystonia, such as torticollis, laryngeal (adductor) dystonia and blepharospasm. However, it may also be helpful in selected cases of spasticity, writer's cramp and other occupationalcramps, tremor and rigidity. In children, its main indication remains cerebral palsy, although it has also been successfully used in patients suffering from squinting, tics, laryngeal dystonia and self-mutilatory stereotypes. The main 'pros' of treatment with botulinus toxininclude: its simplicity; its ability to be carried out on an outpatient basis; the general lack of side effects; focality; possible incremental strategies; the fact that a single treatment may suffice if combined with physiotherapy; the fact that any type of muscular hyperactivity may be treated; the possibility of dramatic overall improvement; its ability to be safely administered along with other treatments; and the fact that it does notproduce permanent disfiguring deformities. The main 'cons' include: the possibility of very costly treatment; development of antibodies; the fact thatthe side effects of prolonged chronic botulinus toxin treatment are unknown; transient excessive weakness; the possibility that abolishing; spasticity may make standing more difficult; and that for certain indications,very large doses of toxin are needed. *
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