The toxin of the anaerobic bacterium CLOSTRIDIUM botulinum is now routinely used to treat focal DYSTONIA in adults. This includes blepharospasm (see EYE, DISORDERS OF), SPASMODIC TORTICOLLIS, muscular spasms of the face, squint and some types of tremor. Injected close to where the nerve enters the aﬀected muscles, the toxin blocks nerve transmissions for up to four months, so relieving symptoms. The toxin is also used in cerebral palsy. Although very eﬀective, there are many possible unwanted eﬀects, especially if too high a dose is used or the injection is misplaced.
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