ABSTRACT
Botulinum, a neurotoxin with muscle relaxant properties, is used in the treatment of strabismus.
Botulism antitoxin, which binds and neutralizes toxin, is used in the treatment of botulism.
Botulinum neurotoxin
is produced by the anaerobic bacterium
Clostridium botulinum
. It is the most poisonous substance known. Very small amounts of botulinum toxin can lead to botulism, a descending paralysis with prominent bulbar symptoms and often affecting the autonomic nervous system (see Chapter 14). Botulism can occur in two ways. It can result from infection with bacterial spores that produce and release the toxin in the body, as in
enteric infectious botulism
, in which the bacteria grow in the intestine, and in
wound botulism
, in which the wound becomes infected. Alternatively, botulism occurs after ingestion of the toxin (
food-borne botulism
). The following are the main features of the clinical use of botulinum toxin:
• Botulinum toxin inhibits release of
acetylcholine
(Ach) at the neuromuscular junction and in cholinergic sympathetic and parasympathetic neurons.
