TREATMENT OF CIRRHOSIS USING BOTULINUM TOXIN
Botulinum toxin for use in treating cirrhosis in a patient in need thereof is provided. The treatment comprises administering botulinum toxin to the patient. The botulinum toxin may be administered by subcutaneous or intradermal injection. The subcutaneous or intradermal injection may be administered to and/or around the vicinity of a trigeminal nerve, a cervical nerve, a thoracic nerve, a lumbar nerve, a sacral nerve, or a combination thereof of the patient.
1 . A method for treating cirrhosis in a patient in need thereof, comprising
administering botulinum toxin to the patient, thereby treating cirrhosis, wherein the administering for an adult comprises, by subcutaneous or intradermal injection to a dermatome, injecting 1-4 units to and/or around the vicinity of a trigeminal nerve, 1-4 units to and/or around the vicinity of a cervical nerve, lateral to the patient's spine, 1-4 units to and/or around the vicinity of a thoracic nerve, lateral to the patient's spine, 1-4 units to and/or around the vicinity of a lumbar nerve, lateral to the patient's spine, and/or 1-4 units to and/or around the vicinity of a sacral nerve, lateral to the patient's spine, and
monitoring if the patient's neuroexcitatory substances level normalizes.
2 . The method of claim 1 , wherein the trigeminal nerve comprises an ophthalmic nerve, maxillary nerve, mandibular nerve, supraorbital nerve, supratrochlear nerve, infraorbital nerve, lacrimal nerve, nasociliary nerve, superior alveolar nerve, buccal nerve, lingual nerve, inferior alveolar nerve, mental nerve, an auriculotemporal nerve, lesser occipital nerve, a greater occipital nerve, or a combination thereof.
3 . The method of claim 1 , wherein the cervical nerve comprises a c-2 nerve, c-3 nerve, c-4 nerve, c-5 nerve, c-6 nerve, c-7 nerve, c-8 nerve, or a combination thereof.
4 . The method of claim 1 , wherein the thoracic nerve comprises a t-2 nerve, t-3 nerve, t-5 nerve, t-6 nerve, t-7 nerve, t-8 nerve, t-9 nerve, t-10 nerve, t-11 nerve, t-12 nerve, or a combination thereof.
5 . The method of claim 1 , wherein the lumbar nerve comprises an 1-1 nerve, 1-2 nerve, 1-3 nerve, 1-4 nerve, 1-5 nerve, or a combination thereof.
6 . The method of claim 1 , wherein the sacral nerve comprises an s-1 nerve, s-2 nerve, s-3 nerve, s-4 nerve, s-5 nerve, or a combination thereof.
7 . The method of claim 1 , wherein the botulinum toxin comprises botulinum toxin type A, botulinum toxin type B, botulinum toxin type C, botulinum toxin type D, botulinum toxin type E, botulinum toxin type F and botulinum toxin type G, a fragment thereof, a hybrid thereof, a chimera thereof, or a combination thereof.
8 . The method of claim 1 , wherein each of the subcutaneous or intradermal injection is bilateral.
9 . The method of claim 1 , wherein a total dosage of the botulinum toxin for an adult who weighs about 150 lbs is between about 1 and about 150 units.
10 . The method of claim 1 , wherein a total dosage of the botulinum toxin for an adult or a child is adjusted for age, weight, or a combination thereof.
11 . The method of claim 1 , wherein the neuroexcitatory substances comprise substance P, CGRP or glutamate.
12 . The method of claim 1 , wherein the patient's neuroexcitatory substances level is blood level.
13 . The method of claim 1 , wherein the monitoring if the patient's neuroexcitatory substances level normalizes comprises monitoring if the patient's blood glutamate level normalizes.
14 . The method of claim 13 , wherein a normal blood glutamate level is from about 40 to about 60 uM.
15 . The method of claim 1 , wherein if the patient's neuroexcitatory substances level fails to normalize, additional botulinum toxin is administered to the patient.
16 . The method of claim 15 , wherein if the patient's neuroexcitatory substances level fails to normalize even after administering the additional botulinum toxin, an antagonist to the neuroexcitatory substances is administered to the patient.
17 . The method of claim 1 , wherein if the patient's neuroexcitatory substances level fails to normalize, an antagonist to the neuroexcitatory substances is administered to the patient.
18 . The method of claim 1 , wherein the monitoring if the patient's neuroexcitatory substances level normalizes occurs one or two weeks after the administering botulinum toxin to the patient.
19 . The method of claim 1 , further comprising monitoring the patient's physical symptoms.
20 . The method of claim 19 , wherein if the patient's physical symptom continues, additional botulinum toxin or an antagonist to the neuroexcitatory substances is administered to the patient.