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Botulinum Toxin Type B: Approved for Neurologic Disorder, But Used in Plastic Surgery

KEY POINT

Botulinum toxin type B (Myobloc Injectable Solution—Elan) last month became the first agent approved by FDA for treatment of cervical dystonia, a neurologic movement disorder in which contractions of a person’s neck and shoulder muscles force abnormal and sometimes painful positions. One of the world’s most potent toxins, botulinum toxin type B works when injected directly into overactive muscles by interrupting the cholinergic transmission between the nerve and the affected muscle, causing the treated muscle to relax. But like the already-marketed botulinum toxin type A (Botox Purified Neurotoxin Complex—Allergan), the greatest use of Myobloc may be for treatment of wrinkles and other off-label indications.

SOURCES

Hallett M. One man’s poison—clinical applications of botulinum toxin. N Engl J Med. 1999;341:118–20.

Brin MF et al. Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia. Neurology. 1999;53:1431–8.

Brashear A et al. Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia. Neurology. 1999;53:1439–46.