Botulinum toxin injections
Botulinum toxin is a purified protein that is extracted from bacteria under controlled laboratory conditions. The brands available are Botox®, Dysport® and Xeomin®. Intramuscular injection of botulinum toxin is a common medical procedure to treat spasticity and can be safely performed in outpatient rooms without visiting a hospital. The procedure involves injecting botulinum toxin into the affected muscles under ultrasound guidance. Once injected the medication blocks the release of acetylcholine, a neurotransmitter, from the nerve which then allows muscle fibres to gradually relax. It takes 1-2 weeks for this change to commence. The duration of effect is variable but the medication remains active for at least 3 months. The benefits may be improved through participation in a therapy and orthotic program although repeat injections are usually required for ongoing clinical benefit. It is important to note that botulinum toxin can be less effective if spasticity has become severe, so the sooner spasticity is diagnosed, the better the outcome can be.
Botulinum toxin is listed on the Pharmaceutical Benefits Scheme for the treatment of spasticity. This means it can be accessed at little or no cost to the patient, making this procedure far more affordable than it has been in the past.