Botulinum toxin (BT) is used to treat a large number of muscle hyperactivity syndromes. Its use in dystonia, however, is still one of the most important indications for BT therapy. When BT is injected into dystonic muscles, it produces a peripheral paresis which is localised, well controllable and follows a distinct and predictable time course of around 3 months. Adverse effects are always transient and usually mild, long-term application is safe. With this profile BT can be used to treat cranial dystonia, cervical dystonia and limb dystonia including writer’s and musician's cramps. The recent introduction of BT high dose therapy also allows to treat more wide-spread dystonia including segmental and generalised dystonia. BT can easily be combined with other anti-dystonic treatments such as deep brain stimulation and intrathecal baclofen application. Best treatment results are obtained when BT therapy is integrated in the multimodal and long-term 'multilayer concept of treatment of dystonia'. The biggest challenge for the future will be to deliver state of the art BT therapy to all dystonia patients in need, regardless of whether they live in developed countries or beyond.

肉毒杆菌毒素 (BT) 用于治疗大量肌肉活动过度综合征。然而，它在肌张力障碍中的应用仍然是 BT 治疗最重要的适应症之一。当 BT 被注射到张力障碍肌肉中时，它会产生局部的、可控的外周麻痹，并遵循大约 3 个月的明显和可预测的时间过程。副作用总是短暂的，通常是温和的，长期应用是安全的。通过这种配置，BT 可用于治疗颅肌张力障碍、颈肌张力障碍和肢体肌张力障碍，包括作家和音乐家的痉挛。最近引入的 BT 高剂量疗法还允许治疗更广泛的肌张力障碍，包括节段性和全身性肌张力障碍。BT 可以很容易地与其他抗肌张力障碍治疗相结合，例如深部脑刺激和鞘内巴氯芬应用。当 BT 疗法与多模式和长期“肌张力障碍治疗的多层概念”相结合时，可获得最佳治疗效果。未来最大的挑战将是为所有有需要的肌张力障碍患者提供最先进的 BT 治疗，无论他们是生活在发达国家还是其他国家。