January 8, 2008
Eugene Lai, M.D., director of the MEDVAMC Parkinson’s Disease Research, Education, and Clinical Center treats U.S. Navy veteran Clinton Lindsey with therapeutic botulinum toxin during a recent appointment. PHOTO: Bobbi Gruner, MEDVAMC Public Affairs Officer
HOUSTON - The second Tuesday of every month may seem like a regular day for many, but for staff in the Parkinson’s Disease Research, Education, and Clinical Center (PADRECC) at the Michael E. DeBakey VA Medical Center (MEDVAMC), the bustle of activity begins early in preparation for a specialized clinic – the “BOTOX® Clinic.”
Botox is the brand name for therapeutic botulinum toxin, an ultra purified neurotoxin. Most people know Botox as a cosmetic treatment for facial wrinkles and aging of the skin; however, this special medication is also used by health care providers to treat severe muscle spasms.
One of the common causes of severe muscle spasms is dystonia, a neurological condition that refers to twisting movements which lead to painful contractions in the shoulders, arms, legs, trunk, head, and neck. It may progress to sustained abnormal postures, such as wry neck and facial twitching. Patients living with strokes, traumatic brain injury, spinal cord injuries, and multiple sclerosis may also experience painful spasticity and sometimes benefit from botulinum toxin treatments.
When injected into muscles that are in spasm (also known as involuntary contractions), botulinum toxin is a complex protein that binds to the nerves and prevents the release of a neurochemical, acetylcholine. This blocking action reduces the spasm of the muscles and produces a temporary paralysis of the nerve function. The medical term for the Botox injections is chemical denervation.
“The purpose of the procedure is to assist patients in facilitating their rehabilitation goals and to reduce the pain caused by intense spasms,” said Linda Fincher, R.N., PADRECC assistant clinical director.
Fincher, together with neurologists, Eugene Lai, M.D., Jyh-Gong Hou, M.D., and Aliya Sarwar, M.D., and Clinical Coordinator Diane Davis, R.N., treat an average of 25 patients each month with the Botox medication. The injections are given with small insulin syringes and patients may be injected in multiple sites depending on the location and intensity of their spasms and pain. Patients receive almost immediate relief from their painful spasms because the medication works within 48 to 72 hours and reaches its peak effect at one to four weeks. Veterans are scheduled to return to the Botox Clinic every three to four months for evaluation and additional injection treatments if needed.
“We strive to offer our veterans the latest advances in the field of neurology. Botox is just one tool to offer hope and an improved quality of life for veterans living with painful muscle spasms and other movement disorders,” said Lai, PADRECC director.
The VA took a major step toward improving patient care and pursuing a cure for Parkinson’s disease by establishing six PADRECCs, one at the Michael E. DeBakey VA Medical Center in Houston. Operating as a national consortium, each PADRECC conducts research covering basic biomedicine, rehabilitation, health services delivery, and clinical trials.
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