Objective: This review discusses the use of BT in various motor and non-motor symptoms of Parkinsonism. This review discusses the use of BT in various motor and non-motor symptoms of Parkinsonism.

Background: Botulinium Toxin(BT) is one of the most potent neurotoxin approved for the management of focal as well as generalized dystonia. It transiently alleviates the hyperactivity of the muscle by causing pre-synaptic blockage of release of Acetyl-choline at neuromuscular junction.  30% of patients of Parkinsons Disease(PD) present with dystonia. Although, there are no large scale randomized controlled trials and hence are not approved by Food and Drugs Administration for their use. However, number of open label studies support their use. This review discusses the use of BT in various motor and non-motor symptoms of PD.

Method: A literature search was undertaken with key words ‘parkinsonism’, ‘botulinium’ and the narrative of the review was formulated based on critical review of the articles.

Results: BT is found to be effective in the management of management of dystonia associated with Parkinsonism including Cervical dystonia, limb dystonia, oromandibular dystonia and laryngeal dystonia. It is also helpful in management of tremors, sialorrhea, bladder dysfunction, hyperhidrosis, gastrointestinal dysfunction. However, no significant benefits have been found in case of   striatal deformity, camptocormia, freezing of gait, depression and pain associated with PD.

Conclusion: BT does offer significant benefits from various motor as well as motor symptoms of PD. However, the scope of its use can be expanded to disease modifying properties in rat models. The real scope of use of BT in PD needs to be further explored.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/botulinium-toxin-in-treatment-of-parkinsonism/