Botulin toxin, also known as Botox, is a neurotoxic protein
produced by the bacterium Clostridium botulinum. It is the most
poisonous naturally occurring substance in the world. A single
drop is capable of killing 50,000 people. Though it is highly
toxic, it is used in minute doses both to treat painful muscle
spasms, and as a cosmetic treatment in some parts of the world.
It is sold commercially under the brand names Botox and Dysport
for this purpose. The terms Botox and Dysport are trade names
and are not used generically to describe the neurotoxins produced
by Clostridia species.
The German physician and singer Justinus Kerner called botulinum
toxin "sausage poison", as this bacterium often causes
poisoning by growing in badly handled prepared meat products.
He first conceived a possible therapeutic use of botulinum toxin.
In 1870, Muller (another German physician) coined the name botulism,
from Latin botulus = "sausage". In 1895, Emile Van
Ermengem first isolated the bacterium Clostridium botulinum.
In 1944, Edward Schantz cultured Clostridium botulinum and isolated
the toxin, and, in 1949, Burgen's group discovered that botulinum
toxin blocks neuromuscular transmission. Throughout the 1950s,
the toxin was used experimentally in the medical cosmetic treatment
of politicians. Then actor-turned-politician Ronald Reagan is
rumoured to be one of the earliest patients of this microexpression-concealing
By 1973, Alan B Scott, MD, of Smith-Kettlewell Institute used
botulinum toxin type A (BTX-A) in monkey experiments, and, in
1980, he officially used BTX-A for the first time in humans
to treat strabismus. In December 1989, BTX-A (BOTOX) was approved
by the US Food and Drug Administration (FDA) for the treatment
of strabismus, blepharospasm, and hemifacial spasm in patients
over 12 years old. The cosmetic effect of BTX-A was initially
described by the Carruthers, a dermatologist/ophthalmologist
husband and wife team although the effect had been observed
by a number of independent groups. On April 15, 2002, the FDA
announced the approval of botulinum toxin type A (BOTOX Cosmetic)
to temporarily improve the appearance of moderate-to-severe
frown lines between the eyebrows (glabellar lines). BTX-A has
also been approved for the treatment of excessive underarm sweating.
The acceptance of BTX-A use for the treatment of spasticity
and muscle pain disorders is growing, with approvals pending
in many European countries and studies on headaches (including
migraine), prostatic symptoms, asthma, obesity and many other
possible indications are ongoing.
Dysport is a therapeutic formulation of the type A toxin developed
and manufactured in the UK and which is licenced for the treatment
of focal dystonias and certain cosmetic uses in many territories
Botulinum Toxin Type B (BTX-B) received FDA approval for treatment
of cervical dystonia on December 21, 2000. Trade names for BTX-B
are Myobloc in the United States, and Neurobloc® in the