Botulinum toxin is a biological agent that blocks chemical signals going from the nerves to the muscles. This weakens the specific injected muscles for a period of up to several months, and provides relief for several common neurological diseases. With proper precautions this treatment is extremely safe and effective. Botulinum toxin has been FDA approved for chronic migraines, spasticity and dystonia in the U.S. In our clinic we have several neurologists who are trained and experienced in the use of botulinum toxin for these conditions. Dr. Bernardo Rodrigues, the director of our Movement Disorders Clinic, uses botulinum toxin injections to treat chronic migraine, dystonia, tremor and hemifacial spasms. Dr. Sanjay Mittal, director of our Stroke Program, uses this therapy to help with spasticity associated with stroke and other conditions.
Spasticity is an increase in the baseline muscle tone, resulting in muscle stiffness. This can affect movements and speech. Spasticity is usually caused by damage to the central nervous system and can be seen in a variety of neurological conditions. Multiple sclerosis and stroke are the most common causes of spasticity of the limbs. Spasmodic dysphonia leads to spasticity of the vocal cords and speech difficulty. Botulinum toxin type A (Botox®) injections have been FDA approved for the treatment of spasticity for decades. When well indicated and appropriately injected it can result in pain relief, improvement of posture and increased function. The benefits from botulinum toxin injections are increased by physical therapy, occupational therapy and speech therapy. Please ask your doctor or physiatrist if botulinum toxin might be appropriate for you.
Blepharospasm is an involuntary contraction (blinking) of both eye lids. This results in eye closure and can interfere with vision and function. Blepharospasm is usually a form a focal dystonia, but it can be seen in other conditions. While the pathophysiology of blepharospasm is not well understood, the treatment has been revolutionized by the use of botulinum toxin, which is so effective that we rarely use oral medications at this point. Regular injections of botulinum toxin can reduce symptoms with minimal side effects in most cases.
Hemifacial spasm is a movement disorder that results in brief involuntary contractions of one side of the face. These abnormal movements can be socially embarrassing and can interfere with vision and chewing. The cause is unknown, and may involve inflammation of the facial nerve or compression of the of the nerve by blood vessels. Treatment options include oral medications, neurosurgical microvascular decompression (“Janetta’s procedure”) and injections of botulinum toxin. Botulinum toxin type A (Botox®) is highly effective for the treatment of hemifacial spasm and benefits can last 3-4 months after each injection. Request an appointment online with one of our movement disorders specialists to discuss the risks and benefits of this therapy.
Botulinum toxin type A (Botox®) has been beneficial for other neurological problems, though it has not been FDA approved for these conditions. Such “off-label” indications include sialorrhea (excessive salivation and drooling), hyperhydrosis (excessive sweating), tics and tremors. Request an appointment online with one of our movement disorders specialist to discuss whether botulinum toxin may be helpful for you.