High Versus Low Concentration Botulinum Toxin A for Benign Essential Blepharospasm: Does Dilution Make a Difference?

Abstract

Compared with the control, the high concentration botulinum toxin A demonstrated a 58% reduction in perceived pain. Patients did not report a significant difference in efficacy or complications with either dilution.

To switch from Botox to Dysport in children with CP, a real world, dose conversion, cost-effectiveness study

“…Both animal and human studies indicate that more extensive dilution enhances the efficacy of each U of toxin by increasing the volume administrated and thereby the extent of diffusion [204][205][206]. However, other studies, including two on children with spastic CP [207,208], have concluded that the efficacy is independent of dilution [207,209,210]. Injection of larger volumes can be more painful and has been reported to give more side-effects due to the spread of toxin to nearby muscles [207,210].…”

Detection of Botulinum Toxin Muscle Effect in Humans Using Magnetic Resonance Imaging: A Qualitative Case Series

“…Clinical studies in spasticity suggest that higher BT doses result in greater clinical effect [35][36][37][38], but also increase adverse events and unwanted effect in adjacent muscles [35][36][37]. Information on the impact of dilution for spasticity [4,[7][8][9][10][11], dilution in other BT indications [39][40][41][42], and BT movement into adjacent muscles for nonÀspasticity-related injections is mixed [43][44][45]. In summary, animal and human data are inconclusive in characterizing BT distribution within muscle after injection, as well as factors associated with that distribution.…”

Agrin Influences Botulinum Neurotoxin A-Induced Nerve Sprouting via miR-144-agrin-MuSK Signaling

“…Effective duration time is a vital factor that limits the clinical applications of BoNT/A. There have been several attempts to prolong the duration of BoNT/A effect, including usage of higher dosages, high-volume preparation, and electrical stimulation post-injection (Dressler, 2004;Rha et al, 2008;Boyle et al, 2009;Hu et al, 2009). However, the results of these approaches were unsatisfactory.…”