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Mechanism of action of botulinum toxin [12]. (a) Normal synaptic transmission; arriving active channel opens voltage-gated calcium channels, allowing influx of calcium. Calcium allows synaptic vesicle docking via SNARE proteins, neurotransmitter release, and activation of post-synaptic potential. (b) Neuronal uptake of onabotulinumtoxinA, internalisation of botulinum toxin via synaptic vesicle, and cleavage of SNAP-25 protein causing inhibition of neurotransmitter release.
