Table 7.

Parkinson’s disease (PD)-related conditions amenable to treatment with BoNT.

Dystonia -BSP/lid apraxia -Bruxism -Limb dystonia -Cervical dystonia -Camptocormia -Levodopa-induced dyskinesia [225], discussed in table	Numerous studies have tried treating various dystonic symptoms in patients with Parkinson’s disease [224,226,227].
Jaw tremors	In three patients with PD jaw tremor who underwent Dysport injection, mean dose of 53 units into each masseter and improvement was noted in jaw tremor in all three patients without side effects [228].
Freezing of gait	Freezing of gait (FOG) is thought to be due to activation of both agonist and antagonist muscle in the legs, which is similar to pathophysiology of dystonia, hence studies have looked into botulinum for freezing of gait [229,230].
Sialorrhea	Increased drooling is seen in about 10% of PD [231] and multiple studies have looked at used of botulinum injection for sialorrhea [231,232].
Overactive bladder	In four PD and two MSA patients with overactive bladder (OAB) complaints, 200 U BoNTA was injected into detrusor, and all patients experienced relief of symptoms without systemic adverse effects [233]. Similar results were seen in eight PD patients with OAB post-BoNTA [234].
Constipation	In a study with PD patients with constipation (after excluding those related to slow movement in colon), in an open-label study, Botox was injected into puborectalis muscles and noted improvement in symptoms in 10 patients at 2 months [235].

BoNT—Botulinum toxin; BoNTA—Botulinum toxin A; MSA—Multiple system atrophy; PD—Parkinson’s disease; OAB—Overactive bladder.