BACKGROUND: The medication known for smoothing a wrinkled brow can also relieve uncontrollable muscle tightness that prevents many patients from functioning normally. Botulinum Toxin, commonly knows as Botox, can paralyze and kill if consumed in contaminated food. But it's now safely used, in a purified form, as a medicine to control certain conditions marked by involuntary muscle contractions.

SPASTICITY: This is a condition that occurs after a stroke, in multiple sclerosis and cerebral palsy patients or those suffering from traumatic brain injuries. Muscles become overactive and tighten uncontrollably. These spasms cause pain and can prevent a person from moving normally.

HOW IT WORKS: Once in the body, the toxin binds to nerve endings at the point where the nerves join muscles. This prevents the nerves from signaling the muscles to contract. The result is weakness and paralysis in that muscle. Botox is not approved by the FDA to treat spasticity, but doctors can prescribe the medication if they think it will be helpful.

FOR CEREBRAL PALSY: The botulinum toxin is thought to relieve cerebral palsy symptoms by reducing tightness in muscles, which allows better control of movement, and increasing the stretch of muscles, reducing the risk of permanent muscle contractions. It works by blocking the signal that nerves are trying to pass to the muscle. Some success has been seen in treatments of muscle spasms, tiptoe walking, and the side effect of drooling.

FOR STROKE: Botox works to relieve muscle tightness from a stroke the same way it eases the wrinkles from a forehead. When injected into a muscle, Botox blocks the transmission of messages sent by the nerve to tell a muscle to contract. Wake Forest University Baptist Medical Center has opened a clinic that will use Botox to treat tight muscles that almost one-third of stroke patients experience. Allison Brashear, M.D., a neurologist, studied the use of Botox to treat spasticity in 2001. Botox, given multiple times over the course of a year, can make it easier for stroke patients with spasticity to dress and care for themselves. Dr. Brashear will head the new clinic. It will be located at Wake Forest Baptist's CompRehab Plaza.

HOW LONG DOES IT LAST? The drug injections usually don’t manifest symptoms of recovery until a few days after the injections. The effects are usually long-lasting, however, and depending on the amount and where it was injected; Botox therapy can last from four to eight months.

SIDE EFFECTS: Botox therapy is a safe and effective treatment when given in very small amounts by a qualified neurologist. Some patients experience temporary weakness in the group of muscles being treated. Flu-like symptoms develop in some, but doctors say it is rare.