Abstract
Botulinum toxin is an established treatment in neurological practice for the management of dystonic syndromes and spasticity. A number of other uses are claimed in these patents, including the management of pain, tremor (for example in Parkinson’s disease) and tinnitus. Delivery of botulinum toxin by means of a controlled release implant would facilitate its use, since the toxin must currently be given by injection, usually every three months. The evidence base on which these claims are made is weak, but if substantiated would represent significant advances in clinical practice.