Avtor/Urednik		Gregorič, Milan Roman
Naslov		Uporaba toksina botulin v zdravljenju kronične bolečine
Prevedeni naslov		Use of botulinum neurotoxin for the treatment of chronic pain
Tip		članek
Vir		Rehabilitacija
Vol. in št.		Letnik 5, št. 1-2
Leto izdaje		2006
Obseg		str. 90-6
Jezik		slo
Abstrakt		Botulinum neurotoxin inhibits acetylcholine release at the neu- romuscular junction which results in muscle paresis. Serologi- cal types A (Botox, Dysport) and B (Myobloc/NeuroBloc) are clinically used in treatment of several syndromes, in particular those related to focal excessive involuntary muscle activity in dystonia and spasticity of adults and children. Muscle relaxati- on follwing botulinum treatment gives also pain relief. Clinical experiences and experimental data indicate that botulinum toxin relieves pain not only through muscle relaxation; the analgesic effect may be exerted also by some others not yet completely recognized pharmacological and neurophysiologi- cal mechanisms. Treatment with botulinum toxin is more effective when used by experienced personnel whithin an inter- disciplinary management. A beneficial therapeutic effect of botulinum toxin was shown also in neck and low back pain, myofascial pain syndromes and primary headache including migraine. Analgesic effect of botulinum toxin in these syndro- mes were not completely revealed according to the criteria of the evidence based medicine. In spite of numerous encouraging recent data in literature a widespread clinical use of botulinum toxin would not yet be recommended.
Izvleček		Toksin botulin je živčni strup, ki zavira sproščanje acetilholina na živčnomišičnem stiku in tako hromi mišice. Serološka tipa toksina A (Botox, Dysport) in B (Myobloc/NeuroBloc) uporabljamo klinično za zdravljenje številnih sindromov, predvsem tistih, ki so povezani z žariščno pretirano in nehoteno dejavnostjo mišic pri distoniji in spastičnosti otrok ter odraslih. Sproščanje mišic po botulinski terapiji zmanjšuje tudi bolečine. Klinične izkušnje in podatki raziskav kažejo, da toksin ne deluje na bolečine le prek mišic, ampak tudi na druge, farmakološko in nevrofiziološko še ne povsem pojasnjene načine. Botulinska terapija je učinkovitejša, če jo izvajajo izkušeni strokovnjaki v okviru interdisciplinarne obravnave. Ugotovljeno je tudi ugodno delovanje toksina na bolečine v vratu in križu, pri miofascialnih bolečinskih sindromih in primarnem glavobolu, tudi pri migreni. Protibolečinski učinki toksina botulin pri teh sindromih še niso zanesljivo preverjeni po kriterijih znanstveno utemeljene medicine. Kljub številnim obetavnim podatkom v literaturi širša klinična uporaba toksina za zdravljenje bolečine še ni priporočljiva.
Deskriptorji		MUSCLE SPASTICITY BOTULINUM TOXINS PAIN DYSTONIA MUSCLE CRAMP HEADACHE MYOFASCIAL PAIN SYNDROMES