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Excessive sweating (hyperhidrosis)
People with hyperhidrosis sweat heavily and persistently—even when they’re not doing anything particularly strenuous. As can be imagined, this condition often leads to significant social embarrassment, due not only to the excess sweat, but also to the accompanying body odor. Deodorants, absorbent powders and other topical products are often ineffectual, and oral medications for the condition can produce unpleasant side effects, including blurred vision and heart palpitations.
Injections of botulinum toxin can reduce the production and release of sweat from the body’s sweat glands. The toxin works by stopping the muscles in the treated area from repeatedly contracting. Such contractions cause sweating. Treatments generally last up to six months. Side effects are minor, but include muscle weakness and bruising.
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Cervical dystonia
Cervical dystonia (spasmodic torticollis) is a medical condition that causes muscles in the neck and shoulders to tighten or spasm uncontrollably. Sometimes the spasms force the head into an abnormal position. The symptoms often worsen during times of stress and/or physical activity.
By relaxing the affected muscles, botulinum toxin has been shown in clinical studies to improve the symptoms of cervical dystonia—greatly reducing neck pain, improving the abnormal tilt of the head, and helping restore daily function.
Eyelid muscle spasms (blepharospasm)
Blepharospasm is a condition in which the eyelid muscles repeatedly and uncontrollably narrow or close. The condition causes abnormal blinking and/or eye tics. It can sometimes result in what is essentially functional blindness—an inability of the eyelids to stay open long enough for the person to see. The cause of blepharospams is unknown, but it’s believed to be associated with some kind of dysfunction in the basal ganglion, the area of the brain that controls the affected muscles.
Oral medications have been developed for blepharospasm, but they often don’t work. Surgically removing some of the muscles and nerves of the eyelids is another treatment option. But many people with blepharospasm often prefer botulinum toxin treatments. The toxin is injected directly into the eyelid muscles, temporarily immobilizing them. The improvement in symptoms is almost immediate and may last for up to six months.
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Other uses
Botulinum toxin is used off label to help minimize the muscles spasms associated with many movement disorders, including cerebral palsy, multiple sclerosis, stroke, and Parkinson’s disease. Some research suggests it may also help minimize migraines. Treatments for these kinds of medical conditions carry serious risks, however, because the drug is more likely (when compared with cosmetic treatments) to spread to muscles needed for breathing, swallowing and other vital functions. In April 2009, after several reports of children with cerebral palsy dying after such treatments, the FDA began requiring that botulinum toxin drugs carry a sterner warning of their health risks.
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