Ungewöhnliche therapeutische Anwendungen von Botulinumtoxin

Zusammenfassung

Die muskellähmende Wirkung von Botulinumtoxin wurde in den 80er Jahren zunächst bei kraniozervikalen Dystonien und beim Spasmus hemifacialis eingesetzt und 1993 in Deutschland zur Therapie zugelassen. Weitere Zulassungen – nicht für alle Toxine in gleicher Weise – folgten für Spastik, infantile Zerebralparese, axilläre Hyperhidrose, chronische Migräne und überaktive Blase. Darüber hinaus ist eine Vielzahl von ungewöhnlichen Indikationen realisiert worden – von der Wundheilungsstörung und unterschiedlichsten Drüsensekretionsstörungen über neuropathische Schmerzen bis hin zur Depression. Allerdings wurden viele ungewöhnliche Indikationen lediglich auf kasuistischer Basis oder offenen Serien beschrieben und beruhen auf einem niedrigen Evidenzniveau.

Abstract

Botulinum toxin was initially used for its muscle-paralyzing action first in craniocervical dystonia and hemifacial spasm in the 80s and was licensed for therapy of these conditions in Germany in 1993. Other approvals – not for all toxins in the same way – followed for spasticity, cerebral palsy, axillary hyperhidrosis, chronic migraine, and overactive bladder. In addition, it has been used to treat a variety of unusual indications– from wound healing, various disturbances of secretory glands and neuropathic pain through to depression. However, its efficacy in many unusual indications has been described only in case reports or open series and the level of evidence is low.

Schlüsselwörter

Botulinumtoxin - Therapie - ungewöhnliche Indikationen - Off-Label-Indikationen - Justinus Kerner

Key words

botulinum toxin - therapy - uncommon indications - off-label indications - Justinus Kerner

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