Masterclass at AMTRD Highlights Real-World Applications of Botulinum Toxin in Movement Disorders: Laxman Bahroo, MD

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“I think the main takeaway is to understand the role of botulinum toxins in movement and related disorders.”

Botulinum toxin has become an important therapeutic tool in neurology, with established applications across a variety of movement and related disorders. By blocking the release of acetylcholine at the neuromuscular junction, the therapy temporarily reduces excessive muscle activity, helping to alleviate symptoms such as abnormal posturing, involuntary muscle contractions, stiffness, and excessive salivation. Common neurologic indications include cervical dystonia, limb dystonia, spasticity, chronic migraine, and sialorrhea, among others. Multiple clinical trials and evidence-based guidelines have supported the efficacy and safety of botulinum toxin formulations for these conditions, leading to their widespread adoption in neurologic practice.¹

Over the past two decades, advances in injection techniques and muscle localization have improved the precision and effectiveness of botulinum toxin therapy. While electromyography (EMG) has long been used to identify overactive muscles, ultrasound guidance is increasingly being incorporated into clinical practice, allowing clinicians to visualize anatomy and needle placement in real time. The complementary use of EMG and ultrasound may improve muscle targeting and optimize outcomes, particularly in patients with complex movement disorders who require individualized treatment approaches.²

One of the sessions at the 2026 Advanced Therapeutics in Movement & Related Disorders (ATMRD) Congress, held June 5-7 in Washington, DC, focused on the clinical application of botulinum toxin in neurologic disorders. The masterclass, led by Laxman Bahroo, MD, professor of neurology at MedStar Georgetown University Hospital, provided attendees with a hands-on educational experience that included live patient evaluations, treatment planning, and real-time demonstrations of injection techniques.

In a follow-up interview, Bahroo discussed the goals of the ATMRD 2026 Botulinum Toxin Masterclass, highlighting its hands-on approach to injection education. The conversation covered live patient evaluations, treatment planning, dosing strategies, and injection techniques, as well as the growing role of ultrasound-guided injections and their integration with electromyography (EMG). The discussion also touched on expectation setting and the expanding clinical applications of botulinum toxin therapy.

Click here for ATMRD 2026 coverage.

REFERENCES:
1. Simpson DM, Hallett M, Ashman EJ, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache. Neurology. 2016;86(19):1818-1826. doi:10.1212/WNL.0000000000002560.
2. Albanese A, Barnes MP, Bhatia KP, et al. A systematic review on the clinical use of botulinum toxin type A in adult spasticity. Eur J Neurol. 2010;17(Suppl 2):1-8. doi:10.1111/j.1468-1331.2010.03125.x.