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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.