Neuro-muscular blocade/ chemodenervation

Selective denervation of nerves and muscles. Botulin toxin,phenol (3-7%),and alcohol 45-100%

Chemodenervation
Phenol, alcohol diffuse few millimetres from injection site Denervation with alcohol 3-6 months, Phenol denervation 4-8 months. Effective but side effects of Pain at injection site, Non-selective protein denaturation, Possible permanent muscle fibrosis, Dysaethesias lasting for several weeks.

Chemodenervation
Botox for dynamic spasticity Post-operative or post-treatment pain control, Focal dystonia, Muscle imbalance producing or contributing to skeletal deformity, As a diagnostic trial, Drooling reduction

Chemodenervation
Botulinum A associated with fewer complications ,greater reversibility of effects and ease of drug administation. Used in the management of focal spasticity. Common side effects are muscle soreness, pain on injection, rash, fatigue, excessive weakness, influenza-like symptoms, infection and allergic reactions.

Chemodenervation
Botox 2-6 u/kg body weight,maximum dose of 29 u/kg reported. 1 unit of botox equivalent to 3-5 units of dysport. For dysport dose 30 u/kg body weight recommended,maximum dose 1000 units.

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