ABSTRACT
INTRODUCTION Treatment with botulinum toxin has fast become the mainstay for the management of focal dystonias. Its wide utility lies in the fact that, by harnessing the chemical denervation properties of this toxin, one can functionally weaken the endpoint of dystonia irrespective of its etiology. The goal of this chapter is to summarize the molecular and cellular mechanisms of botulinum toxin, highlighting areas that need further investigation and practical treatment issues in need of optimization. Such an understanding of the principles of botulinum toxin action is paramount to developing the next generation of therapeutic agents.
