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Botulinum Toxin Injections—Medical
(Botulinum Toxin Type A; Botulinum Toxin Type B; Botox Injections)
Reasons for Procedure
- Cervical dystonia—abnormal spasms of neck muscles
- Blepharospasm—spasm of eyelid muscles
- Strabismus —crossed eyes
- Hyperhydrosis —excessive sweating
- Chronic migraines
- Tension headaches
- Achalasia —spasm of esophageal muscles causing difficulties in swallowing
- Spasmodic dysphonia
- Muscle spasms due to cerebral palsy
- Spasticity associated with multiple sclerosis
- Spasticity in leg and arm muscles due to brain injury/stroke
- Focal limb dystonias
- Incontinence due to bladder problems
- Anal sphincter disorders
- Peripheral nerve pain
- Temporomandibular disorder (jaw disorder)
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- Stinging around the injection sites
- Flu -like symptoms
- Excessive weakness of the muscle around the eyes—can cause drooping of the eyelids or obstruction of vision
- Difficulty swallowing—can occur in patients receiving injections in their neck
- Compensatory hyperhidrosis—people being treated for hyperhidrosis may develop increased sweat production at another area of the body
- Excessive weakness or wasting in certain muscles—the injection may slow any improvement in the muscle
- Neck weakness in people with long, thin necks
- Risk of the botulinum toxin spreading beyond the injection area—may cause botulism symptoms, including difficulty breathing and death in severe cases. Children with cerebral palsy may be at a higher risk for this side effect.
- This procedure may worsen nerve or muscle disorders, such as:
- Have an infection or inflammation in the area where botox will be injected
- Are sensitive to the ingredients in botox
- Are pregnant or breastfeeding
What to Expect
Description of the Procedure
- Remain upright for several hours
- Avoid alcohol
How Long Will It Take?
Will It Hurt?
Call Your Doctor
- Difficulty breathing
- Difficulty swallowing
- Difficulty speaking
- Severe lower eyelid droop or obstructed vision
- Excessive weakness around the injection site
- Rash or any other sign of an allergic reaction
American Society for Dermatologic Surgery http://www.asds.net
American Society of Plastic Surgeons http://www.plasticsurgery.org
Canadian Dermatology Association http://www.dermatology.ca
Health Canada http://www.hc-sc.gc.ca
Allergan Physician Production Information. Botox cosmetic (botulinum toxin type A). Published April 2008.
FDA approves Botox to treat chronic migraines. US Food & Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm. Published October 15, 2010. Accessed February 12, 2014.
Ondo WG, Gollomp S, Galvez-Jimenez N. A pilot study of botulinum toxin A for headache in cervical dystonia. Headache. 2005;45(8):1073-1077.
Ward A, Roberts G, Warner J, et al. Cost-effectiveness of botulinum toxin type A in the treatment of post-stroke spasticity. J Rehabil Med. 2005;37(4):252-257.
11/4/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA gives update on botulinum toxin safety warnings. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm175013.htm. Updated August 3, 2009. Accessed November 4, 2009.
3/19/2010 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA approves Botox to treat spasticity in flexor muscles of the elbow, wrist and fingers. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm203776.htm. Updated March 9, 2010. Accessed March 19, 2010.
5/17/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis. JAMA. 2012;307(16):1736-1745.
- Reviewer: Rimas Lukas, MD
- Review Date: 02/2014
- Update Date: 02/12/2014