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Doody's Review ServiceReviewer: Ross Bogey, DO (Rehabilitation Institute of Chicago)
Description: This book presents many of the clinical uses of the relatively new drug, botulinum toxin. Several of the chapters are excellent, particularly the review of mechanism of action and applicability in the treatment of spasticity, pain, sialorrhea and blepherospasm. However, the book attempts to cover nearly all uses of the medication known to the assorted authors, including potential treatments for which there is little peer-reviewed literature.
Purpose: The purpose is to provide an overview of this medication, and present clinical scenarios in which the drug might be an appropriate choice. However, the scope is too broad and many of the potential treatments are poorly supported by the available literature.
Audience: The target audience should be clinicians (physicians and therapists) with an introductory knowledge of how to use this drug. One concerning aspect of the book is the relative inexperience of the contributing authors. Nearly one-third are resident physicians, and the expertise of several of the staff physicians cannot be determined from their biographies or publication records.
Features: The best parts of the book are the chapters related to well described conditions treatable with botulinum toxins: spasticity, pain, headache, hyperhydrosis, and blepherospasm. The chapter on mechanism of action is particularly well written. The greatest shortcoming is in the parts devoted to treatment of conditions where there is little peer-reviewed evidence that treatment with botulinum toxins is beneficial; one example is treatment of plantar fascitis. The authors' description of their respective injection techniques would be better served in a workshop environment.
Assessment: Most of the relevant ideas in this book can be found easily via web sites devoted to treatment of movement disorders or spasticity (e.g., WeMove.org).