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Radiología (English Edition) Uses and technique of ultrasound-guided botulinum toxin infiltration
Journal Information
Vol. 67. Issue 6.
(November - December 2025)
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3
Vol. 67. Issue 6.
(November - December 2025)
Radiology today
Uses and technique of ultrasound-guided botulinum toxin infiltration
Usos y técnica de la infiltración ecoguiada de toxina botulínica
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3
J. Llorente Perisa,
Corresponding author
jllorente.rx@gmail.com

Corresponding author.
, J. Miranda Bautistaa, P. Menéndez Fernández-Mirandaa,b
a Servicio de Radiodiagnóstico, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
b Escuela Politécnica Superior, Universidad CEU San Pablo, Madrid, Spain
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Table 1. Dosage and dilutions of botulinum toxin in normal saline for the indications described in this article.
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Abstract

Botulinum toxin (BT) is a neurotoxin that causes flaccid paralysis by inhibiting the release of acetylcholine at the neuromuscular junction, and it may lead to long-term muscle atrophy. It is used to treat conditions associated with muscle hypertrophy or to enhance muscle flexibility, thereby facilitating surgical procedures. It has been shown that ultrasound-guided administration is superior to the anatomical landmarks technique as it reduces side effects and improves efficacy. Although some applications are not officially approved, evidence supports its efficacy and safety in the treatment of various conditions. Some of these more established conditions include anterior abdominal wall hernias, piriformis syndrome, thoracic outlet syndrome, bruxism, spasticity and cervical dystonia. The objective of this study is to review the uses of botulinum toxin in muscular and neuromuscular disorders, analysing its efficacy, safety and the importance of ultrasound guidance in its administration.

Keywords:
Botulinum toxin
Abdominal wall
Piriformis syndrome
Thoracic outlet syndrome
Pectoralis minor syndrome
Bruxism
Resumen

La toxina botulínica (TB) es una neurotoxina que, al inhibir la liberación de acetilcolina en la unión neuromuscular, provoca parálisis flácida y puede llevar a atrofia muscular a largo plazo. Se emplea en patologías asociadas a hipertrofia muscular o para incrementar la flexibilidad muscular, facilitando así las cirugías. Se ha demostrado que su administración guiada por ecografía es superior a la técnica basada en referencias anatómicas, ya que disminuye los efectos secundarios y mejora la eficacia. Aunque algunas aplicaciones no están incluidas en la ficha técnica, hay evidencia de su eficacia y seguridad en el tratamiento de múltiples patologías, algunas de ellas más estandarizadas como hernias de la pared abdominal anterior, síndrome del piriforme, síndrome del opérculo torácico, bruxismo, espasticidad y distonía cervical. El objetivo de este estudio es revisar los usos de la toxina botulínica en patologías musculares y neuromusculares, analizando su eficacia, seguridad y la importancia de la guía ecográfica en su administración.

Palabras clave:
Toxina botulínica
Pared abdominal
Síndrome piriforme
Síndrome opérculo torácico
Síndrome pectoral menor
Bruxismo

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