Innervation zone targeted botulinum toxin injections


KAYMAK B., KARA M., YAĞIZ ON A., SOYLU A. R. , ÖZÇAKAR L.

EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE, vol.54, no.1, pp.100-109, 2018 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 54 Issue: 1
  • Publication Date: 2018
  • Doi Number: 10.23736/s1973-9087.17.04663-9
  • Journal Name: EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.100-109
  • Keywords: Muscle spasticity, Dystonia, Innervation zone, Neuromuscular junction, Botulinum toxins, MOTOR END-PLATES, SKELETAL-MUSCLES, TOPOGRAPHICAL LOCALIZATION, ISOMETRIC CONTRACTION, ELECTRON-MICROSCOPE, JOINT ANGLE, FIBER TYPES, BICEPS, DIFFUSION, NEUROTOXIN

Abstract

Muscle overactivity (spasticity, dystonia or spasm) seen in certain neuromuscular disorders has been effectively treated with intramuscular injection of botulinum neurotoxins (BTXs). Since they act in the nerve terminals, toxins must be transported to the neuromuscular junctions which are generally clustered in one or more restricted areas (innervations zone(s) (IZs)) in a skeletal muscle. Likewise, IZ targeted BTX injections using guidance is highly recommended to achieve an optimal therapeutic goal with lower doses and fewer side effects. Hence, detection of the injection sites should be based on the knowledge about the localization of the IZs and also the transport mechanism of BTX in skeletal muscle is crucial for intramuscolar application of BTX.