Botulinum toxin type A (BoNT-A) is a widely used neurotoxin for managing spasticity. It works by temporarily weakening targeted muscles through blocking the release of acetylcholine at the neuromuscular junction. The treatment involves intramuscular injections guided by ultrasound, electromyography (EMG), nerve stimulation, or a combination of these methods to accurately identify the target muscle.

The effects typically last up to 3 months, after which nerve sprouting and re-innervation restore muscle function, requiring repeat injections for continued benefits.

While generally safe, BoNT-A injections can have side effects, including allergic reactions, flu-like symptoms, or generalisedmuscle weakness. Repeated injections can, in rare cases, trigger the production of neutralisingantibodies, potentially reducing the treatment’s effectiveness. However, this risk is minimisedwith newer formulations of the drug.