PMID: 11320861Apr 26, 2001Paper

Botulinum toxin A for the treatment of headache disorders and pericranial pain syndromes

Der Nervenarzt
Hartmut GöbelK Austermann

Abstract

For 20 years botulinum toxin A has been used for the treatment of a variety of disorders characterised by pathologically increased muscle contraction. Recently, treatment of tension headache, migraine, cluster headache, and myofascial pain syndromes of neck, shoulder girdle, and back with botulinum toxin A has become a rapidly expanding new field of research. Several modes of action are discussed for these indications. The blockade of cholinergic innervation reduces muscular hyperactivity for 3 to 6 months. Degenerative changes in the musculoskeletal system of the head and neck are prevented. Nociceptive afferences and blood vessels of the pericranial muscles are decompressed and muscular trigger points and tender points are resolved. The normalisation of muscle spindle activity leads to a normalisation of muscle tone and central control mechanisms of muscle activity. Oromandibular dysfunction is eliminated and muscular stress removed. However, the effect of botulinum toxin A cannot be explained by muscular actions only. Its retrograde uptake into the central nervous system modulates the expression of substance P and enkephalins in the spinal cord and nucleus raphe. Recent findings suggest an inhibition of sterile inflammation ...Continue Reading

Citations

Nov 2, 2004·Mund-, Kiefer- und Gesichtschirurgie : MKG·D NolteK-D Wolff
Mar 6, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Paul J ChristoJulie A Freischlag
Jul 4, 2002·Current Pain and Headache Reports·Joanne Borg-Stein
Jun 28, 2003·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Bhertha Miyuki Tamura, Bobby Chang
Mar 11, 2004·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Arnold William Klein
Sep 2, 2006·Current Pain and Headache Reports·Joanne Borg-Stein, Allen Wilkins
Nov 26, 2010·Current Pain and Headache Reports·Paul J Christo, Kai McGreevy

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