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| Botulinum Toxin Injection Therapy |
WHAT IS BOTULINUM TOXIN and WHAT IS IT USED FOR?
Botulinum toxin is a protein produced by the bacterium Clostridium Botulinum. Used in minute doses, it
can treat a variety of painful or embarrassing conditions including:
■ painful or disfiguring muscle spasms caused by dystonia (including spasmodic torticollis or cervical
dystonia, blepharospasm, oromandibular dystonia, foot dystonia and writer's cramp)
■ hemifacial spasm
■ muscle overactivity due to spasticity
■ excessive sweating or hyperhidrosis
■ chronic migraine headaches
The location and quantity of Botox injections required to achieve maximal effect is ascertained. No
anaesthetic is required. After your treatment, the effect of the injections develops over a 5-7 day period
and lasts 3 to 6 months
HOW DOES BOTULINUM TOXIN WORK?
Muscular disorders
Botulinum toxin injections work by locally blocking the communication between nerves and muscles
When these signals are blocked, the release of acetylcholine is prevented. Acetylcholine is
neurotransmitter found in the body and when its release is blocked, the affected muscles are rendered
unable to contract. Patients treated with botulinum toxin injections usually notice the effects 3 days to 2
weeks following treatments. After approximately 3 months, the effects of the botulinum toxin will diminish
The success of a botulinum toxin injection depends on:
■ the dose
■ the injection site in the muscle
■ experience of the physician administering the injection
■ clear communication between the physician and patient regarding the symptoms being treated and
the potential outcomes
It is important to remember that it may take more than one cycle of injections before the optimal benefit is
achieved
Patient specific treatment plans
Treatment with botulinum toxin injections should be administered by a trained physician however
collaboration from various specialties is very helpful for developing a comprehensive treatment plan.
Your doctor may refer you to other specialties that work closely together including physical and
occupational therapy, psychology, psychiatry and social work
What else can be done to help with the symptoms?
Stress can worsen the symptoms of dystonia. Using stress management and relaxation techniques may be
beneficial. Education is vital when dealing with a dystonia diagnosis and reassurance from family, friends
and others is beneficial. Support groups can be beneficial
What should I do now that I have been diagnosed with dystonia?
Knowledge is an important tool. Work with your doctor to find a treatment plan that works for you. There
are other interventions that may be considered to help alleviate symptoms. Be sure to alert your doctor if
your treatment plan has undesirable side effects or if you have questions or concerns. Remember to
persevere and keep a positive attitude
Hyperhidrosis
Research has shown that using local injections of botulinum toxin to alleviate the symptoms of
hyperhidrosis is safe and effective. In one clinical study involving 322 patients with severe underarm
sweating, 81% of the patients receiving botulinum toxin injections achieved a greater than 50% reduction
in sweating. And, 50% of the patients had their excessive sweating relieved for nearly 7 months
ARE THERE POTENTIAL SIDE EFFECTS?
Side effects from botulinum toxin injections are infrequent and transient. For blepharospasm patients,
mild side effects may include drooping of the eyelid, blurred vision, facial asymmetry and double vision.
Tearing may occur
General side effects of botulinum toxin injections may include pain, tenderness and/or bruising at the
injection site, difficulty swallowing, upper respiratory infection, neck pain and headache. Most side
effects recover spontaneously
Rare but serious side effects include severe problems swallowing, serious heart problems and severe
allergic reactions. If you are experiencing a severe side effect, contact emergency services immediately
WHAT IS INVOLVED?
Muscular disorders
Botulinum toxin injections can be administered in a physician's office, require relatively little time, and do
not demand any restrictions in work or leisure activity (aside from refraining from intensive exercise or
the use of a sauna on the day of the injections)
For muscular condition, a fine needle is used to inject small amounts of botulinum toxin into the muscle -
in some cases with guidance techniques such as electromyography. Multiple injections are typically used
In subsequent visits, injection effects are evaluated and dosing modified according to the individual's
response aiming for the optimal injection locations and dosages
Hyperhidrosis
During the procedure, a very fine needle is used to inject small amounts of botulinum toxin just under the
skin near the sweat glands responsible for excessive perspiration. Multiple injections are given based on
your doctor's assessment of the area that needs to be treated. Injections into the palms or soles may be
painful. To ease discomfort, physicians may use one or more of a number of anesthetic techniques such
as pain-killing creams, nerve blocks, ice, or vibrations
There is a possibility that during the procedures some sweat glands may be missed. As a result, you may
continue to experience some sweating from the untreated areas. If this happens, it's important to talk to
your doctor so that he or she can reevaluate the sweating areas and perhaps "fill in" the gaps with
additional injections
Botulinum toxin injections do not cure hyperhidrosis; symptoms will return gradually. Follow-up injections
are required to maintain dryness. These repeat injections may be necessary at intervals varying from
seven to sixteen months
Botulinum toxin is a protein produced by the bacterium Clostridium Botulinum. Used in minute doses, it
can treat a variety of painful or embarrassing conditions including:
■ painful or disfiguring muscle spasms caused by dystonia (including spasmodic torticollis or cervical
dystonia, blepharospasm, oromandibular dystonia, foot dystonia and writer's cramp)
■ hemifacial spasm
■ muscle overactivity due to spasticity
■ excessive sweating or hyperhidrosis
■ chronic migraine headaches
The location and quantity of Botox injections required to achieve maximal effect is ascertained. No
anaesthetic is required. After your treatment, the effect of the injections develops over a 5-7 day period
and lasts 3 to 6 months
HOW DOES BOTULINUM TOXIN WORK?
Muscular disorders
Botulinum toxin injections work by locally blocking the communication between nerves and muscles
When these signals are blocked, the release of acetylcholine is prevented. Acetylcholine is
neurotransmitter found in the body and when its release is blocked, the affected muscles are rendered
unable to contract. Patients treated with botulinum toxin injections usually notice the effects 3 days to 2
weeks following treatments. After approximately 3 months, the effects of the botulinum toxin will diminish
The success of a botulinum toxin injection depends on:
■ the dose
■ the injection site in the muscle
■ experience of the physician administering the injection
■ clear communication between the physician and patient regarding the symptoms being treated and
the potential outcomes
It is important to remember that it may take more than one cycle of injections before the optimal benefit is
achieved
Patient specific treatment plans
Treatment with botulinum toxin injections should be administered by a trained physician however
collaboration from various specialties is very helpful for developing a comprehensive treatment plan.
Your doctor may refer you to other specialties that work closely together including physical and
occupational therapy, psychology, psychiatry and social work
What else can be done to help with the symptoms?
Stress can worsen the symptoms of dystonia. Using stress management and relaxation techniques may be
beneficial. Education is vital when dealing with a dystonia diagnosis and reassurance from family, friends
and others is beneficial. Support groups can be beneficial
What should I do now that I have been diagnosed with dystonia?
Knowledge is an important tool. Work with your doctor to find a treatment plan that works for you. There
are other interventions that may be considered to help alleviate symptoms. Be sure to alert your doctor if
your treatment plan has undesirable side effects or if you have questions or concerns. Remember to
persevere and keep a positive attitude
Hyperhidrosis
Research has shown that using local injections of botulinum toxin to alleviate the symptoms of
hyperhidrosis is safe and effective. In one clinical study involving 322 patients with severe underarm
sweating, 81% of the patients receiving botulinum toxin injections achieved a greater than 50% reduction
in sweating. And, 50% of the patients had their excessive sweating relieved for nearly 7 months
ARE THERE POTENTIAL SIDE EFFECTS?
Side effects from botulinum toxin injections are infrequent and transient. For blepharospasm patients,
mild side effects may include drooping of the eyelid, blurred vision, facial asymmetry and double vision.
Tearing may occur
General side effects of botulinum toxin injections may include pain, tenderness and/or bruising at the
injection site, difficulty swallowing, upper respiratory infection, neck pain and headache. Most side
effects recover spontaneously
Rare but serious side effects include severe problems swallowing, serious heart problems and severe
allergic reactions. If you are experiencing a severe side effect, contact emergency services immediately
WHAT IS INVOLVED?
Muscular disorders
Botulinum toxin injections can be administered in a physician's office, require relatively little time, and do
not demand any restrictions in work or leisure activity (aside from refraining from intensive exercise or
the use of a sauna on the day of the injections)
For muscular condition, a fine needle is used to inject small amounts of botulinum toxin into the muscle -
in some cases with guidance techniques such as electromyography. Multiple injections are typically used
In subsequent visits, injection effects are evaluated and dosing modified according to the individual's
response aiming for the optimal injection locations and dosages
Hyperhidrosis
During the procedure, a very fine needle is used to inject small amounts of botulinum toxin just under the
skin near the sweat glands responsible for excessive perspiration. Multiple injections are given based on
your doctor's assessment of the area that needs to be treated. Injections into the palms or soles may be
painful. To ease discomfort, physicians may use one or more of a number of anesthetic techniques such
as pain-killing creams, nerve blocks, ice, or vibrations
There is a possibility that during the procedures some sweat glands may be missed. As a result, you may
continue to experience some sweating from the untreated areas. If this happens, it's important to talk to
your doctor so that he or she can reevaluate the sweating areas and perhaps "fill in" the gaps with
additional injections
Botulinum toxin injections do not cure hyperhidrosis; symptoms will return gradually. Follow-up injections
are required to maintain dryness. These repeat injections may be necessary at intervals varying from
seven to sixteen months
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Dr Andrew H Evans
Flemington Neurology
Flemington Neurology
Suite 105
55 Flemington Road
North Melbourne, Victoria 3051
admin@flemingtonneurology.com
t: 03 9348 9381 f: 03 9329 1473
55 Flemington Road
North Melbourne, Victoria 3051
admin@flemingtonneurology.com
t: 03 9348 9381 f: 03 9329 1473
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 | General Neurology |
| Botulinum toxin injection treatments |
| Dystonia and hyperhydrosis |
| Migraine and headaches |
| Nerve conduction studies and Electrodiagnostic services |
| Multidisciplinary care for the management of complex movement | |
| disorders cases including: |
| assessment for deep brain stimulation procedures for treatment of Parkinson's | |
| disease, tremor, dystonia and dystonic motor tics |
| assessment for apomorphine infusion treatment for Parkinson's disease | |