Movement Disorders

The therapeutic use of botulinum neurotoxins (BTX) has evolved most dramatically in the field of movement disorders and has been applied to a wide spectrum of dyskinesias. In addition to the clinical benefits derived from BTX therapy in a variety of movement disorders, studies of the neurophysiologic effects of BTX have provided considerable insights into the functional organization and control of neuromuscular activity.

 

Non-Inflammatory Pain

A majority of these neurological disorders can be identified with “trigger points” in a muscle group. The treatment of choice is the introduction of chemicals that de-enervate these trigger points – accordingly, use of neurotoxins such as Botulinum Toxin, are escalating rapidly. There are also alternative medicine alternatives, such as “biopuncture”, that can be carried out in a cost effective manner. Myoguide can also be used to support  “dry needling” procedures as well.

 

Cosmetics

Current cosmetic indications for BOTOX® injections include hyperfunctional lines such as  glabellar, forehead, crow’s feet, platysma, and nasolabial lines.  Injection guidance is recommended for areas adjacent to the eye, such as glabellar and crow’s feet, and thin muscles such as platysma.  There is a benefit to verify the injection will be in muscle when considering injection into these areas to avoid potential iatrogenic effects.  This is especial true for novice injectors.

 

Botox Cosmetic

Cosmetic treatments with Botox® have been growing at an exponential rate for many years. The role of EMG guidance in this field is focused on specific areas where injection accuracy is depended on to avoid vital structures. Poor injection targeting can result in a droopy appearance for 3-4 months. This is a dreaded iatrogenic result that can be avoided by simply using EMG guidance to confirm injection into the muscle of interest. This is particularly useful for new injectors looking for confirmation before injecting drugs into patients. The need to increase accuracy when injecting neuromodulators has been highlighted by recent FDA reviews of the dangers of peripheral effects.