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WHAT IS BOTOX?
Botox is a substance
produced by a bacterium called Clostridium botulinum. It has been purified under
very strictly controlled conditions.
How does it work?
Your nervous system
controls all of your body movements. If this system fails to work properly, some
of your muscles may contract without warning, causing uncontrollable muscle
spasms to occur. This is called Dystonia.
Botox is injected in
extremely small amounts into affected muscles. The exact way it works is quite
complicated, but the end result is that it blocks nerve impulses to relax the
muscle and relieve the spasm.
I’ve heard of
something called botulism. I understand it’s a very serious illness. Is Botox
related to botulism?
This is very
important question. The active ingredient in Botox is the same one which, in
much larger amounts, can cause botulism. But knowing what botulism is, and how
different it is from the way Botox works, can take away any fear you might have.
Botulism poisoning,
although rare, can occur if a person eats food which is contaminated with
Clostridium botulinum bacteria. The toxin may also be produced in infected cuts
or wounds; that’s what tetanus shots are for. The bacteria make large amounts
of toxin which circulate all through the body. This can lead to respiratory
paralysis, which is sometimes fatal.
However, because
only extremely small doses of Botox are ever used, it can be injected directly
into specific muscles to relieve spasm and suffering safely. Other areas and
functions are unaffected.
Many drugs in common
use would be harmful if given in large enough doses, or in such a way as to
affect the entire body. But given in the appropriate way in the right amounts,
they are valuable allies in fighting illness and suffering. Clinical studies
over more than 15 years have shown that Botox is effective and produces few side
effects.
How do I know my
doctor won’t give me too much Botox?
Production of Botox
is carefully controlled at every stage to be sure it is safe for medical use.
Your doctor has been specially trained to use it safely and to manage any
problems that may occur.
Are there any
patients who should not receive Botox?
Botox should not be
given to anyone who has reacted badly in the past to any of its ingredients.
Your doctor will ask you about this. And it shouldn’t be used if there is
infection or inflammation in the part of the body where the injection is to be
given.
Pregnant or nursing
women should not be treated with Botox, because it is not known if it might harm
the baby.
What does Botox
look like?
Botox comes in glass
vials containing a small amount of crystals. A special solution containing water
and a small amount of salt is added just before use to make it ready for
injection.
Where do I go for
the injection?
Botox injections are
given by physicians specialising in the injection procedure.
How is it given?
A freshly made
solution of the drug is injected into the affected muscle(s), using a disposable
syringe with a fine needle. For injection into muscles that are hard to
identify, the may use a technique called electromyography to be sure that the
needle is in the right muscle. Muscles affected by Dystonia produce extra
electrical activity which electromyography can detect. After injection reduced
electrical activity shows that the desired effect has been obtained.
In some disorders in
which many muscles are involved, several injections may be required.
Does the
injection hurt?
Botox itself does
not cause irritation or inflammation when it is injected. Patients occasionally
complain briefly of discomfort or pain at the injection site. This may be due to
the amount of fluid injected or some other factor unrelated to the drug.
Are there any
side effects?
Side effects may
occur, but they are usually mild, don’t last long and be treated. Serious side
effects are uncommon, and no long term complications have been reported.
Side effects vary,
depending on where Botox is injected and for what purpose. A full discussion of
side effects is beyond the scope of this article. Your doctor can tell you which
ones might apply to you. However most patients find that the relief of symptoms
far outweighs any discomfort the drug may cause.
Does Botox
interact with other drugs?
It is always
important to let your doctor know if you are taking any other drugs. Certain
antibiotics or other that interfere with nerve impulses to muscles may increase
the effect of Botox. However patients can usually be treated with Botox
regardless of other drugs they may be taking.
If Botox is
injected into or near the eye, is there a danger of damaging the eyeball?
Not a single case of
permanent eye damage resulting from Botox injection has occurred.
How long does
Botox take to work?
Effects are usually
noticed within 5 to 10 days. You may be asked to come back about a week after
the first injection, so the doctor can assess your response.
Will Botox cure
me?
No, it is not a
cure. However, Botox offers the best hope yet for safe, effective and
long-lasting relief of pain and spasm.
How long do the
effects of the injection last?
For most patients, a
single treatment with Botox relieves symptoms for several months.
Does that mean I
will need more injections?
Yes, most likely.
Except in few conditions, the injected muscles eventually get over the drug’s
effects. Repeated injections must be given to maintain the benefit over a long
period of time. The treatment can be repeated for as long it is required.
Most patients will
need injections about every three months. The exact timing is determined by the
patient’s sense of need and the doctor’s estimation of recovery of muscle
function.
Will additional
injections continue to be effective?
Given in appropriate
doses at appropriate intervals, repeated treatments usually remain effective
over a long period of time.
What benefits can
I expect of Botox treatment?
Botox relieves
symptoms effectively. Pain is reduced and movement is often restored to
"normal". Botox can relieve the chronic pain many patients have
suffered from for years. And it causes very few side effects.
Treatment with Botox
is simple and convenient. The risks, expense and inconvenience of hospital
admission and surgery are avoided. Time lost from work is reduced.
Botox treatment can
result in greatly improved quality of life, even for patients who have suffered
for many years with no relief from other treatments. People who have been
confined to their homes by their disability can find themselves able to resume
normal lives once their symptoms have been controlled by Botox.
Are there any
disadvantages?
The only
disadvantages of any consequence are the need for repeated injections, and the
occurrence of side effects in some patients.
If injections are
given too often, antibody formation could theoretically interfere with response
to treatment. This is not a problem, however, because your doctor takes this
into account when deciding how often to repeat the injection.
Taken from Dystonia
Medical Research Foundation,
Chicago
booklet "What is Botox" We Move
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