Der Erfolg des therapeutischen Einsatzes von Botulinumtoxin in den 90er Jahren bei Bewegungsstörungen, fokalen Dystonien (z.B. Blepharospasmus, Torticollis spasmodicus) und Spasmus hemifacialis führte zu einer breiten Akzeptanz. In der Zwischenzeit wurde Botulinumtoxin für die Therapie von mehr als 50 Indikationen vorgeschlagen. Zugelassene Massenindikationen stellen bei den Bewegungsstörungen die verschiedenen Formen der Spastik und Dystonie sowie der Zerebralparese dar, ferner der Spasmus hemifacialis. Bei der Spastik ist die Effizienz von Botulinumtoxin neben pflegerischen Indikationen besonders bewiesen, wenn die Haltungsanomalie des Arms subjektiv als stigmatisierend erlebt wird und wenn nach einem Schlaganfall eine schmerzhafte Schulter bei spastischer Hemiparese die Indikation darstellt. Botulinumtoxin ist bei ausgewählten Patienten auch hilfreich bei Tic-Störungen, Krampussyndromen, Myoklonien, Tremor und Rigor.
Because of the successes with the therapeutical injections of botulinum toxin in the 1990s for the treatment of movement disorders, such as the focal dystonias (e.g. blepharospams or torticollis) a hemifacial spasm, botulinum toxin can nowadays be considered an established and widely accepted therapy concept. Meanwhile more than 50 indications for botulinum toxin have been suggested. Major labelled indications include the various forms of focal dystonia and spasticity, as well as cerebral palsy and hemifacial spasm. In spastic motor disorders treatment with botulinum toxin is efficacious for improving hygiene-related disability but also to reduce stigmatisation due to limb position. In addition, botulinum toxin can be helpful for indications such as tics, crampus syndrome, tremor, or rigidity.
Key words
Botulinum toxin - dystonia - spasm - tremor - hyperhidrosis - migraine - tension-type headache
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Korrespondenz
Dr. med. Michael Messner
Oberarzt Neurologisches Krankenhaus München Zentrum für Parkinson und Bewegungsstörungen
Parzivalplatz 4
80804 München
eMail: michael.messner@nk-m.de
