Evidence map›Paper›PMID 40532883›Full record

ReviewToxicon : official journal of the International Society on Toxinology2025

Localization modalities for botulinum neurotoxin injection.

Barbara Illowsky Karp, Ann Ly, Katharine E Alter

Abstract readReview
In one paragraph

Review in Toxicon : official journal of the International Society on Toxinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Barbara Illowsky KarpNational Institute of Neurological Disorders and Stroke, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA. Electronic address: karpb@ninds.nih.gov.
Ann LyMovement Disorders Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
Katharine E AlterNeurorehabilitation and Robotics Section, Rehabilitation Medicine, Clinical Center, National Institutes of Health, 10 Center Drive, Room 1-1469, Bethesda, MD, 20892-1604, USA.

Funding

Intramural NIH HHS Z99 NS999999
6 · The paper itself

Abstract

Botulinum toxin is a targeted therapeutic that acts primarily at the site of injection. Various approaches have been taken to guide injection into the selected muscle, gland, organ or other body area. Guidance methodologies that can be used in the office setting for skeletal muscle and salivary gland percutaneous injection include uninstrumented manual needle placement, electromyography (EMG), electromyography with electrical stimulation (e-stim), ultrasound (US) and combined guidance (US + EMG or US + e-stim). This article reviews the advantages, disadvantages, and accuracy of each method and the impact of each guidance technique on therapeutic outcome for muscle and salivary gland injections. Overall, manual placement may suffice for large and superficial muscles, however, all instrumented techniques improve accuracy. Electromyography can uniquely provide information on muscle activity, while e-stim can aid injection in patients who cannot voluntarily activate a selected muscle. Ultrasound is the only technique that can visualize internal structures, allowing identification of a safe trajectory for injection of small or deep targets that might otherwise be inaccessible.

Indexed as

Botulinum ToxinsElectric StimulationElectromyographyHumansInjections, IntramuscularMuscle, SkeletalSalivary GlandsBotulinum ToxinsAnatomyBotulinum toxinDystoniaElectrical stimulation (e-stim)Electromyography (EMG)GuidanceHypersalivationSpasticityUltrasound

Identifiers

PMID40532883
PMCPMC12259210

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.