Botox, the wonder neurotoxin that has helped iron out wrinkles and creases on several famous faces, is now being used to treat conditions as varied as spasticity, migraine, muscle spasm, multiple sclerosis and excessive sweating.
The wrinkle-killer helped Megha Chandna, 19, get out of bed after two long years. The Haryana state basketball player from Modern Vidya Niketan, Faridabad, developed paralysis when a car hit the scooter she was riding on the way for her Class 12 exams. An injury to her brain resulted in paralysis of the right side, making her unable to use her right leg, hand and fingers.
Two years and three botox injections later, her mother cannot hold back her tears at the sight of her holding a pen in her right hand. “For two years, her right arm stayed folded over her chest, but now she can stretch her arm and move her fingers,” said her mother Kiran Chandna. The first shot was given six months after the accident in August 2009, the second in November 2009, and the third, a year later in November 2010.
“Botox has been used for treating movement disorders, post-stroke spasticity and cerebral palsy for almost 20 years. It can be used in scores of other neurological diseases with positive results,” says Dr Manjari Tripathi, associate professor, department of neurology, All India Institute of Medical Sciences (AIIMS), which has been running a dedicated clinic for people with movement disorders since 1993.
“In any given week, 20 people get injections for various conditions. It’s free for the poor but everyone else has to buy it for treatment,” says a doctor at AIIMS, requesting anonymity. Popularly known as Botox, botulinum toxin was first approved for medical use in 1989 to treat eye muscle disorders, such as spasm, but since then has got approval for treatment of various nerve and muscle-related disorders.
Though the neurotoxin is not approved for treating all these conditions, off-label use under the discretion of the physician is not unusual. “I have been using Botox for neurological diseases for 15 years, with 95% success rate,” says Dr JD Mukherji, head of department, neurology, Max Healthcare, who gives Botox to about 15 people a month.
He uses it to treat people of post-stroke paralysis, facial and other spasms, back pain, stuttering, writer’s cramp, excessive sweating and movement disorders, among others.
“The therapy works at three basic levels: it eases involuntary muscle movement; reduces excessive glandular secretion, and relieves pain by blocking the transmission of the pain sensation to the brain,” says Dr Mukherji.
“It’s not a cure but a therapy that provides temporary relief,” says Dr Vineet Suri, senior consultant neurology, Apollo Hospital, who treats 20 people a month with Botox for paralysis, movement disorders and facial spasms.
Even though it is an expensive treatment, for people in pain, cost is not a bother. Abha Kashyap, 45, chief executive officer, MedSpa, treated her migraine with painkillers for 25 years but the bouts kept increasing. “From six-seven attacks of pain lasting 24 hours, it increased to an attack every other week, lasting for three days. I’d lock myself in a dark quiet room and couldn’t eat because of nausea,” she says.
Just before Botox got approval for treatment of migraine in October in the US last year, her husband, a plastic surgeon, used botox therapy on her six months ago. “The frequency of attacks is reduced to one in two months, with the pain lasting a day or two only. The severity has also reduced, now it feels like a normal headache,” she said.
“I have treated 10 people including my wife for migraine and the pain and severity has reduced considerably in 80 per cent cases,” says Dr Ajaya Kashyap, who has been using botox for cosmetic purposes since 13 years.