สำนักราชบัณฑิตยสภา

«“√ “√ √“™∫— ≥±‘µ¬ ∂“π ªï ∑’Ë Ú˜ ©∫— ∫∑’Ë Û °.§.-°.¬. ÚıÙı π‘ æπ∏å æ«ß«√‘ π∑√å ¯ı˜ Abstract Botulinum Toxin Therapy in Current Practice Niphon Poungvarin Associate Member, the Academy of Science, the Royal Institute, Thailand One of the most recent advances in clinical practice in the past 20 years is treatment with botu- linum toxin. Botulinum toxin was used for the first time in 1977 to correct strabismus. Later, several indications for botulinum toxin therapy were listed, including conditions such as blepharospasm, hemifacial spasm, spasmodic torticollis, writer’s cramp and spasticity. Currently, there are more than 50 indications for botulinum toxin therapy, including gastrointestinal sphinctor problems, spas- modic dysphonia, musculoskeletal pain and cosmetic purposes (to treat wrinkles and facial folding). Botulinum toxin acts upon the neuromuscular junction at the presynaptic site to prevent the release of acetylcholine, thus acting by chemodenervation. The clinical efficacy of botulinum toxin lasts for 4-6 months after injection. The Division of Neurology, Department of Medicine, Faculty of Medi- cine Siriraj Hospital is the first center in South East Asia to collaborate with the Smith-Kettlewell Eye Research Institute in San Francisco to conduct clinical trials using botulinum toxin in neurologi- cal patients. It has been doing so since 1989, before the Food and Drug Administration of the United States approved this treatment. A paper publised in Thailand was the first document proof of the efficacy of botulinim toxin in the treatment of patients with hemifacial spasm. Now the Thai group is the second most experienced in botulinum toxin therapy apart from the group at New York Uni- versity. More than 2,000 patients have been treated with botulinum toxin therapy for various move- ment disorders at Siriraj Hospital. Key words : botulinum toxin, botulism