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Under the needle

Doctor using Botox to treat neurological disorders

January 23, 2012
By JAMES C. FALCON - Staff Writer (jfalcon@minotdailynews.com) , Minot Daily News

It is usually associated with improving one's appearance, be it to chase away those pesky lines on the forehead or to smooth our wrinkles elsewhere.

At Trinity Hospital, Botox is being used to do more than to just pander to one's vanity.

Botox is one of the "most potent toxins we know 100 grams is good enough to kill all mankind ... When we use it, we use just a tiny amount" but when used correctly, it can alleviate a variety of neurological conditions, explained Dr. Bahram Kordlar, a neurologist at the hospital.

Article Photos

James C. Falcon/MDN - - Dr. Bahram Kordlar, a neurologist at Trinity Health, demonstrates the injection of botox on his nurse, Heather Delquignie, on Jan. 11. Kordlar uses botox to cure neurological maladies, such as chronic migraines.

"Botox is not a cure," he explained on Jan. 11. "We use it as a treatment, like other medication."

Botox, which comes from clostridum botulinum, was first looked at as being a potential treatment in the 1960s after Alan Scott, an ophthalmologist, and Edward Schantz created a preparation for therapeutic purposes. In 1973, Scott used a Type A botulinum toxin in experiments with monkeys before using it officially to treat strabismus or, crossed eyes in 1980.

The Food and Drug Administration approved this use of Botox, as well as to combat blepharospasm, or uncontrolled blinking, and hemifacial spasms, in 1989. The FDA list of Botox use expanded to include cervical cystoma, in 2000, and cosmetic use in 2002.

Dr. William Binder, a plastic surgeon, noticed that patients who had chronic migraines headaches that lasted more than 15 days a month said that following Botox treatments, their migraines went away, Kordlar explained. This use made the FDA's list of acceptable usage in 2010.

Kordlar uses Botox for all of these maladies, with the exception of cosmetic use.

"Botox relaxes muscles and probably has an anti-inflammatory and analgesic effect," Kordlar said in a press release issued earlier this month. "It loosens up the muscles by preventing chemical release from traveling from the nerve endings to the muscle fiber, and in addition it prevents release of substances responsible for pain and inflammation."

Botox is injected into the forehead muscles, temporal muscles and the muscles on the back of the head. In the case of using Botox for chronic migraines, Kordlar said that patients would begin to feel the effects at one week; the benefits last for 12 weeks.

The procedure of Botox as a cure is an expensive process. Kordlar said that between 170 and 180 units of Botox are used for chronic migraines. A vial, which contains 100 units, costs $1,000.

"It's expensive," Kordlar commented, noting that for dystonia, 200 to 400 units are used. For spasms, 100 units. He noted that he only uses Botox for chronic migraines when all else fails. If a patient fails to respond to other medications, he said, Botox is used.

 
 

 

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