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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(4):772-783.
The Effect of Botulinum Toxin Injection on Compound Action Potentials and Repetitive Nerve Stimulation in Rat Gastrocnemius Muscle.
Lee, Eun Ha , Kim, Sei Joo
Department of Rehabilitation Medicine, College of Medicine, Korea University, Korea.
흰쥐 비복근활동전위 및 반복신경자극을 이용한 보툴리눔 독소 효과 연구
이은하, 김세주
고려대학교 의과대학 재활의학교실

Botulinum toxin develops muscular paralysis through the inhibition of acetylcholine release from presynaptic membrane in neuromuscular junction. It has been used clinically to treat strabismus, blepharospasm and spasmodic dysphonia. Recently it was introduced for the treatment of limb spasticity as well. Serial compound muscle action potential(CMAP) amplitudes were measured and repetitive nerve stimulation test(RNST) was performed with 2Hz and 30Hz on the rat gastrocnemius muscle to observe the effect of muscle paralysis. Also, Periodic acid Schiff (PAS) staining sections of the muscle for glycogen was studied to quantify the degree of muscular paralysis.

Thirty Sprague-Dawley rats, 10 for control and 20 for experimental group were studied for 12 weeks. Normal saline 0.025 ml and 0.125 ml was injected into gastrocnemius muscle in cotrol group 1 and 2, respectively. Botulinum toxin type A(Botox) was injected 5.0U/0.025 ml in experimental group 1, 2.5U/0.025 ml in group 2, 2.5U/0.125 ml in group 3, and 0.5U/0.025 ml in group 4. The amplitudes of CMAP declined markedly by 81.1% to 96.5% of basal amplitudes on the first week after Botox injection, but slightly recovered on 12th week by 20.8% to 42.2% with greater recovery in lower dose group. RNST with 2Hz produced no remarkable 1 : 5 amplitude change in experimental group. RNST with 30Hz produced marked increment in 1 : 5 amplitude up to 24.4%. PAS staining for muscle sections showed residual glycogen after tetanic stimulation due to neuromuscular block by Botox.

Key Words: Botulinum toxin A, Compound muscle action potentials, Repetitive nerve stimulation test, Periodic acid Schiff stain


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