Intradermal Grid Injection Mapping
Short placeholder sentence about grid-spaced injections.
- ~1-2 cm: Grid spacing (placeholder note)
- Intradermal: Depth (placeholder note)
- 10-20: Sites/session (placeholder note)
- ~2-5 U: Dose/site (placeholder note)
Iodine-starch test guides injection map
Placeholder line: Minor test stains sweaty skin before grid is drawn.
Axilla vs palm technique differs
Placeholder line: Palms need more sites and cooling due to pain.
Light Chain Cleaves SNAP-25
Short placeholder sentence about SNARE protein cleavage.
- SNAP-25: Target protein (placeholder note)
- Serotype A: Toxin type (placeholder note)
- Zinc protease: Mechanism (placeholder note)
- 2-4 days: Onset (placeholder note)
Heavy chain binds and internalizes toxin
Placeholder line: Receptor binding triggers endocytosis into neuron.
Light chain escapes into cytosol
Placeholder line: Translocation releases protease into terminal.
Blocking Vesicle Fusion and ACh Release
Short placeholder sentence about acetylcholine blockade.
- Acetylcholine: Neurotransmitter (placeholder note)
- Sympathetic cholinergic: Fiber type (placeholder note)
- Up to ~90%: Block level (placeholder note)
- ~2 weeks: Peak effect (placeholder note)
SNAP-25 cleavage stops SNARE complex
Placeholder line: Vesicles cannot dock without intact SNAP-25.
Exocytosis of ACh halts at synapse
Placeholder line: No neurotransmitter reaches gland receptors.
Eccrine Gland Loses Cholinergic Drive
Short placeholder sentence about sweat gland denervation.
- Eccrine sweat gland: Gland type (placeholder note)
- Muscarinic M3: Receptor (placeholder note)
- ~80-90%: Sweat reduction (placeholder note)
- 2-4 days: Onset window (placeholder note)
Secretory cells stop responding
Placeholder line: Without ACh, glands cannot activate secretion.
Clinical dryness follows chemodenervation
Placeholder line: Patient-reported dryness tracks blockade level.
Effect Duration and Re-treatment Interval
Short placeholder sentence about duration and re-dosing.
- ~6 months: Axilla duration (placeholder note)
- ~4-5 months: Palm duration (placeholder note)
- Sweat returns: Re-treat trigger (placeholder note)
- ~2: Sessions/year (placeholder note)
Axon sprouting restores nerve terminals
Placeholder line: New synapses regrow, ACh release resumes.
Re-injection restores blockade level
Placeholder line: Repeat dosing renews the SNARE cleavage cycle.