Table 1.
Indications for botulinum toxin
| Established indications | Tried applications | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Disorders of neuromuscular overactivity | Disorders of neuro-muscular overactivity | Other conditions/disorders | |||||||
| Ophthalmic disorders | Other neuromuscular disorders | Ophthalmic disorders | Other neuromuscular disorders | Spasticity | Neuromuscular disorders | Pain | E.N.T. and oroharyngeal | Disorders of pelvic floor | Cosmetic and dermatological applications |
| Concomitant misalignment | Idiopathic focal dystonias | Disorders of ocular motility (nystagmus, oscillopsia) | Secondary dystonia, | Multiple sclerosis | Myokymia, | Headache (tension type, migraine, cervicogenic), neck, lower back ache | Dhtrooling of saliva, Oromandibular disorders (bruxism, Masseter hypertrophy, temporomandibular joint dysfunction) | Anismus | Wrinkles, face rejuvenation |
| (Primary or secondary esotropia or exotropia) | (torticollis, isolated head tremor, blepharospasm, oromandibular dystonia, lingual dystonia, laryngeal dystonia) | Thyroid disease (upper eyelid retraction, glabellar furrowing) | Tic disorders (simple tics, Tourette's syndrome, dystonic tics) | Stroke | Neurogenic tibialis anterior hypertrophy with myalgia | Myofascial pain | Pharyngeal disorders (cricopharyngeal dysphagia, closure of larynx in chronic aspiration) | Vaginismus | Browlift, crow's feet |
| Nonconcomitant misalignment | Other focal dystonias (writer's cramp, occupational cramps) | Therapeutic ptosis for corneal protection | Tremor (essential, writing, palatal, cerebellar) | Traumatic brain injury | Benign crampfasciculation syndrome | Tennis elbow | Achalasia, | Chronic Anal fissures | Glabellar frown |
| Paralytic strabismus (III, IV, VI nerves palsy, inter-nuclear ophthalmoplegia, skew deviation) | Tardive dystonia | Painful spinal myoclonus | Cerebral palsy | Laryngeal disorders (vocal fold granuloma, ventricular dysphonia, mutational dysphonia) | Detrusorsphincter dyssynergia | Frontalis frown, Bunny nose, Upper lip rhytides Pebbly chin, Naso-labial fold | |||
| Duane's syndrome | Hemifacial spasm/post-facial nerve palsy synkinesis | Parkinson's disease (freezing of gait, off period dystonia, severe constipation) | Spinal cord injury | Stuttering with glottal blocks | Platysma, Venus rings (Horizontal neck rhytides) | ||||
| Restrictive or myogenic strabismus | Cephalic tetanus, stiff man syndrome, neuromyotonia | Palatal myoclonus oesophageal diverticulosis intrinsic rhinitis | Turkey neck (Vertical platysmal bands) | ||||||
| Muscle stiffness, cramps, spasms | Hyperhidrosis: Palms, soles and axillae, gustatory sweating | ||||||||