Indications
BOTOX is a medication made from the botulinum toxin, a substance produced by the Clostridium bacteria. While food containing the toxin can cause Botulism, a type of food poisoning, the medication BOTOX can be helpful in treating spasticity and dystonia.

How BOTOX Works
When diluted and prepared for therapeutic use, the toxin can be injected in minute amounts into spastic and dystonic muscles, where it blocks neuromuscular transmission by binding to receptor sites on motor nerve terminals, inhibiting the release of acetylcholine. This creates a localized chemical denervation on this muscle and renders the muscle weakened, producing the desired effect of quieting the constant firing of the muscles that are causing the spasticity and dystonia.

Current Treatment Limitations
Current treatment for the condition of spasticity and dystonia include neuropharmacological agents, orthotic devices! physical therapy, phenol or alcohol injections, intrathecal baclofen, and surgical interventions. However, neuropharmacological agents are of limited value due to their sedating side effects. Orthotic devices and physical therapy become ineffective with excessive abnormal tone. Phenol and alcohol injections are caustic and may cause permanent damage to surrounding tissues. And intrathecal baclofen and surgical interventions are costly and include risk to the patient.

Useage
Intramuscular injections of BOTOX have been proven to be a simple office procedure with minimal risk and cost. Generally, the first couple of injections are given at three-month intervals, and every six to nine months thereafter. There are no restrictions before or after the medication.

Insurance Coverage
BOTOX is generally paid for by most insurance companies, and approval is sought prior to any injections so payment does not become an issue for the family. It is approved by Medicare and Medicaid.

The Clinic
The BOTOX clinic operates in the orthopaedic clinic on the first floor of the hospital, area 1A.

For More Information
If you or your pediatrician would like additional information or literature regarding BOTOX injection, please feel free to call Bruce E. Bowman, MHS, PA-C, the Orthopaedic Physician Assistant at 860.545.9100.