Botulinum Toxins Injections for Hypertonic Limbs—Is It So Effective?

Dear Colleagues,

Botulinum toxin (BT) is a widely recognized safe and effective treatment, routinely used for various medical conditions, including cervical dystonia (CD), hemifacial spasm (HFS) and blepharospasm. It is now also used to alleviate the upper and lower spasticity of the limbs. The evidence of its efficacy in the treatment of limb dystonia is even more scarce, primarily because it is not covered by insurance in most, if not all, countries. Furthermore, the treatment's effectiveness results have varied among studies. It is uncertain whether one hyperactive disorder of a limb is more responsive to BT than another. In contrast to BT treatment for CD, HFS, post-facial paralysis synkinesis or blepharospams, which was widely proved to be effective and safe, BT treatment for hyperactive limbs lack evidence relating its efficacy. In addition, the dropout rates are high for BT injections of hyperactive limbs, while compliance of BT for facial and cervical muscles is high.

This issue of Toxins is focused on BT treatment of spastic and dystonic limbs. The aim of this issue is to increase our knowledge on the efficacy of BT injections for hyperactive limbs, in order to optimize its efficacy.

Prof. Dr. Gilad Yahalom
Guest Editor

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