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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(5):923-932.
Dose-dependent Responses to Botulinum Toxin A Injection on Compound Muscle Action Potential Amplitude and Electromyography: Local and Distant Effects.
Han, Soo Jeong , Lee, Chyung Ki
Department of Rehabilitation Medicine, Ewha Womans University College of Medicine.
보툴리눔 독소 A에 의한 용량 의존성 근육 마비
한수정, 이청기
이화여자대학교 의과대학 재활의학교실
Abstract

Objective
The purpose of this study was to investigate the dose-dependent responses to botulinum toxin A (BTX-A) injection on compound muscle action potential (CMAP) amplitude and needle electromyography (EMG) in local and distant muscles.


Method
The BTX-A (Botox®, Allergan Co.) was injected to the left tibialis anterior (TA): 2, 4, 6, 8 U for each 4 Sprague-Dawley rats; 5, 10, 15, 20 U for each 2 rats. The sciatic nerve conduction and needle EMG were performed in the right and left TA immediately before BTX-A injection, on 2 days after injection, weekly for 1 to 10 weeks, and then monthly for 4 months.


Results
The range of dose-dependent maximal paralysis of the injected muscle was from 94% to 99.2% on 7 days after injection. With the lapse of time, the amplitudes in the left sciatic nerve conduction recovered, the abnormal spontaneous activities disappeared, and the power in spectral analysis of motor unit action potential increased. The range of dose-dependent reductions of the CMAP amplitude of the right TA was from 41.8% to 69.9% in the distant muscle, but there was no abnormal spontaneous activity in needle EMG study. As higher doses of BTX-A were injected, the degree of amplitude reduction became larger and the duration of amplitude reduction became longer in both local and distant TA muscles.


Conclusion
We observed the dose-dependent muscle paralysis with injection of BTX-A. The systemic effects by local injection were induced and the durations of local and systemic effects were proportional to the BTX-A dosage.

Key Words: Botulinum toxin A, Compound muscle action potential, Needle electromyography


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