Botulinum Toxin: Dosing and DilutionFrancisco, Gerard E. MDAmerican Journal of Physical Medicine & Rehabilitation: October 2004 - Volume 83 - Issue 10 - pp S30-S37 Original Articles: Review & Analysis: Spasticity Abstract Author Information Francisco GE: Botulinum toxin: Dosing and dilution. Am J Phys Med Rehabil 2004;83(suppl):S30–S37. In the United States, the popularity of botulinum toxins as agents to treat muscle hypertonia has grown significantly over the last decade, despite lack of approval from the Food and Drug Administration for the indication of spasticity. Botox (botulinum toxin type A) and Myobloc (botulinum toxin type B) are Food and Drug Administration–approved for other indications, such as cervical dystonia. Another commercial preparation of type A, Dysport, has yet to reach the United States market as of this writing. Although botulinum toxin’s efficacy in influencing spastic hypertonia is well accepted, the impact of certain clinical issues, such as dosing and dilution, on treatment outcome is not well established by published studies. This article will review important articles and selected abstracts on the use of botulinum toxin, specifically for spastic hypertonia in adults, with emphasis on current clinical practices as they relate to dosing and dilution. From the Physical Medicine and Rehabilitation Alliance, Baylor College of Medicine/University of Texas, Houston, Texas; and Research Service, Brain Injury and Stroke Program, The Institute for Rehabilitation and Research, Houston, Texas. All correspondence and requests for reprints should be addressed to Gerard E. Francisco, MD, 1333 Moursund Avenue, Houston, TX 77030. © 2004 Lippincott Williams & Wilkins, Inc.