Botulinum neurotoxin for the treatment of movement disorders

Background Botulinum neurotoxin (BoNT) is an exotoxin that causes neuromuscular weakness. BoNT serotypes A and B have been used for decades for the safe and effective treatment of various movement disorders, including some forms of focal dystonia. These conditions, such as cervical dystonia, hemifacial spasm, blepharospasm and spasmodic dysphonia, can have a substantial impact on patients' quality of life, but are often under-recognised. Objective The aim of this article is to describe the usefulness of BoNT for the treatment of movement disorders, including a description of its mechanism of action, mode of administration, indications and evidence of benefit. Discussion General practitioners have a vital role in the identification of patients with potentially treatable movement disorders such as cervical dystonia. Treatment with BoNT can improve patients' function, reduce pain and improve workforce participation. Patients require ongoing periodic injections by a trained neurologist to obtain long-term benefits with minimal side effects.