ABSTRACT
The family of botulinum neurotoxins includes seven distinct serotypes identified as A, B, Cl, D, E, F and G. Botulinum toxins A and B are currently commercially available worldwide. They are composed of different strains of Clostridium botulinum bacteria and have both distinct and overlapping properties. Botulinum toxin B is trademarked as MYOBLOC in North America and Neurobloc in Europe and is manufactured by Elan Pharmaceuticals. Doses of all botulinum toxin products are described in terms of units of biological activity. Botulinum toxin can elicit an immune response with the production of IgG neutralizing antibodies that will prevent the patient responding to that botulinum toxin in the future. Botulinum toxin B is sold as a stable non-preserved aqueous solution that may be further diluted with normal saline. The primary contraindication for botulinum toxin A therapy is the presence of any associated neuromuscular disorder that could amplify the affect of the neurotoxin.
