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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article comprises a historic description of botulinum toxin (BTX) as a therapeutic substance. The first therapeutic application of BTX injections in humans took place in 1979. It was hoped that surgery for strabismus could be avoided with injections to outer ocular muscles. It was however the positive results in the 1990s against focal dystoniae such as blepharospasm, spasmodic torticollis, and hemifacial spasm that led to broader acceptance of the substance beyond the scope of neurology. Since then BTX has been suggested for therapy of more than 50 indications. Approved mass indications were found in neurology for spasticity and cerebral palsy, in dermatology for focal hyperhidrosis, and in cosmetic medicine for treatment of skin wrinkles. The groundwork has been proceeding for some time pertaining to its approval for further uses in pain therapy and urology.
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PMID:[Botulinum toxin. Development for therapeutic purposes]. 1892 57

The use of botulinum toxin (BoNT) is well established in medical practice. The application of BoNT extends over many indications such as strabismus, blepharospasm, hemifacial spasm, and others. Another indication for the use of BoNT type A is the masseteric muscle hypertrophy to obtain a lower facial contouring. Authors report the treatment of 5 patients with intramuscular injection of BoNT. A high degree of patient and physician satisfaction was noted after the treatment. Authors concluded that BoNT type A can safely be considered as a noninvasive drug treatment for patients with MMH.
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PMID:Lower facial contouring with botulinum toxin type A. 1909 63

The vergence system is an important element in human eye movement control. It comprises horizontal, vertical, and torsional components, the largest of which is convergence. Vergence performance is largely involuntary, although voluntary effort can influence convergence. Vergence function can be damaged by trauma or organic disease and, because convergence can be exerted voluntarily, it is susceptible to purposeful subjective disturbances. Vergence function is important in the maintenance of binocular control, being synonymous with motor fusion. The most common vergence dysfunction affects convergence and may be exhibited as an excess or weakness such as convergence spasm or paralysis. Divergence dysfunction generally presents with diminished function such as divergence weakness; vertical and cyclovergence disturbances are rare. An update is given on the neuroanatomical areas that subserve the vergence system. Clinical examples of the most common vergence disorders are presented. The influence of the vergence system on the diagnosis and management in common and less well-known clinical entities is described and discussed.
Strabismus
PMID:The influence of the vergence system on strabismus diagnosis and management. 1930 Nov 85

Clostridium botulinum neurotoxins (BoNTs) are effective therapeutics for a variety of neurological disorders, such as strabismus, blepharospam, hemificial spasm, and cervical dystonia, because of the toxin's tropism for neurons and specific cleavage of neuronal soluble N-ethylmaleimide-sensitive fusion protein-attachment protein receptors (SNARE) proteins. Modifying BoNT to bind nonneuronal cells has been attempted to extend therapeutic applications. However, prerequisite to develop nonneuronal therapies requires the retargeting the catalytic activity of BoNTs to nonneuronal SNARE isoforms. Here, we reported the engineering of a BoNT derivative that cleaves SNAP23, a nonneuronal SNARE protein. SNAP23 mediates vesicle-plasma membrane fusion processes, including secretion of airway mucus, antibody, insulin, gastric acids, and ions. This mutated BoNT/E light chain LC/E(K(224)D) showed extended substrate specificity to cleave SNAP23, and the natural substrate, SNAP25, but not SNAP29 or SNAP47. Upon direct protein delivery into cultured human epithelial cells, LC/E(K(224)D) cleaved endogenous SNAP23, which inhibited secretion of mucin and IL-8. These studies show the feasibility of genetically modifying LCs to target a nonneuronal SNARE protein that extends therapeutic potential for treatment of human hypersecretion diseases.
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PMID:Engineering botulinum neurotoxin to extend therapeutic intervention. 1948 72

Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world. After years of clinical success and consistent safety in the upper face, the use of BTX has expanded and evolved to include increasingly complicated indications. In the hands of adept injectors, the focus has shifted from the treatment of individual dynamic rhytides to shaping, contouring, and sculpting, alone or in combination with other cosmetic procedures, to enhance the aesthetic appearance of the face. Although recent reports have questioned the safety of BTX, 25 years of therapeutic and over 20 years of cosmetic use has demonstrated an impressive record of safety and efficacy when used appropriately by experienced injectors.
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PMID:Botulinum toxin in facial rejuvenation: an update. 2109 50

Botulinum toxin has long been known for its paralytic effects on the human voluntary musculature via inhibition of acetylcholine release at neuromuscular junctions. Its original clinical use for the treatment of strabismus has expanded significantly to include neurological conditions related to muscle hyperactivity and/or spasticity (e.g., dystonia, spasticity, tics, tremor, dysphonia). Recently, botulinum toxin has been shown to impact autonomic disorders by acting at acceptors on glands and smooth muscle, and consequently it has been used in the management of a number of other conditions including hypersecretory disorders, pain syndromes, detrusor sphinchter dyssenergia or overactivity and gastointestinal smooth muscle/sphincter spasm; it may also reduce pain in patients for whom it is used to treat these and other primary conditions. This article will review the pharmacology and formulations of botulinum toxins as well as data from clinical trials demonstrating their efficacy for numerous conditions based on their effects on cholinergic synapses outside the motor nervous system.
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PMID:Current clinical applications of botulinum toxin. 1992 19

Botulinum toxin, one of the most poisonous biological substances known, is a neurotoxin produced by the bacterium Clostridium botulinum. C. botulinum elaborates eight antigenically distinguishable exotoxins (A, B, C(1), C(2), D, E, F and G). All serotypes interfere with neural transmission by blocking the release of acetylcholine, the principal neurotransmitter at the neuromuscular junction, causing muscle paralysis. The weakness induced by injection with botulinum toxin A usually lasts about three months. Botulinum toxins now play a very significant role in the management of a wide variety of medical conditions, especially strabismus and focal dystonias, hemifacial spasm, and various spastic movement disorders, headaches, hypersalivation, hyperhidrosis, and some chronic conditions that respond only partially to medical treatment. The list of possible new indications is rapidly expanding. The cosmetological applications include correction of lines, creases and wrinkling all over the face, chin, neck, and chest to dermatological applications such as hyperhidrosis. Injections with botulinum toxin are generally well tolerated and side effects are few. A precise knowledge and understanding of the functional anatomy of the mimetic muscles is absolutely necessary to correctly use botulinum toxins in clinical practice.
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PMID:Botulinum toxin. 2041 69

Initially used to treat strabismus in the 1970s, botulinum toxin now has more than a hundred possible medical applications. Its utility in neurologic conditions has largely involved treating movement disorders (particularly dystonia and conditions with muscle hyperactivity), although practically any hyperkinetic movement disorder may be relieved by botulinum toxin, including hemifacial spasm, tremor, tics, myoclonus, and spasticity. Although initially thought to inhibit acetylcholine release only at the neuromuscular junction, botulinum toxins are now recognized to inhibit acetylcholine release at autonomic cholinergic nerve terminals, as well as peripheral release of neurotransmitters involved in pain regulation. Thus, their use in neurology has been expanded to include headache and other pain syndromes, as well as hypersecretory disorders. This article highlights some of the common neurologic conditions currently improved by botulinum toxins and reviews the scientific evidence from research studies and clinical experience with these conditions.
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PMID:An update on the neurologic applications of botulinum toxins. 2056 45

Evaluation of horses for eye problems and for suspected impairment of visual acuity often requires a thorough neuroophthalmic examination to be conducted. Along with a full ophthalmic evaluation, the results of such an examination should indicate the likely site of any lesion(s) accounting for blindness, miosis, mydriasis, anisocoria, Horner's syndrome, strabismus, facial paralysis and facial spasm, nystagmus and other signs of vestibular disease, and cerebellar disorders, that may be present. Such a thorough examination with guidance for correct interpretation of findings is given here.
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PMID:Neuro-ophthalmology: a review. 2093 71

Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world. After years of clinical success and consistent safety in the upper face, the use of BTX has expanded and evolved to include increasingly complicated indications. In the hands of adept injectors, the focus has shifted from the treatment of individual dynamic rhytides to shaping, contouring, and sculpting, alone or in combination with other cosmetic procedures, to enhance the aesthetic appearance of the face. Although recent reports have questioned the safety of BTX, 25 years of therapeutic and over 20 years of cosmetic use has demonstrated an impressive record of safety and efficacy when used appropriately by experienced injectors.
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PMID:Botulinum toxin in facial rejuvenation: an update. 1985 Jan 91


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