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How does Botox work?

Normally, your brain sends electrochemical messages to your muscles to make them contract and move. These messages are transmitted from a nerve to the muscle by a substance called acetylcholine. When too much acetylcholine is released, muscles become overly active and spasm or tense up.

Botox® blocks the nerve from releasing acetylcholine. As a result, the muscle spasms stop or are greatly reduced, providing relief from symptoms. Your health care provider will know how much Botox® is needed to treat you effectively.

It’s important to remember that botulinum toxin treatment is not a cure. For many people, however, its effects have been dramatic. With Botox®, the nerve will take about 3 months to recover and begin to release acetylcholine, and the muscles may become overactive again. At that point, another injection will be needed to provide relief, as long as no allergic reactions or other significant side effects occurred and clinical response was obtained.

Is Botox a new treatment?

No. Botox® has been used for more than 11 years to treat over 1 million patients worldwide, and it is approved by the health ministries of at least 70 countries.

How long can I be treated with Botox?

Each treatment typically lasts 3 months and can be repeated as long as your condition responds to Botox® and you do not have any serious allergic reactions or other significant side effects.

Conditions Treated

  • Cervical Dystonia – severe muscle spasm in the neck and shoulder muscles leading to neck pain and abnormal postures •Strabismus / Blepharospasm – involuntary muscle spasm around the face and eye

It is also used outside this license in the pain clinic for the following conditions:-

  • Myofascial Pain Syndromes – pain arising from skeletal muscles in spasm e.g. neck, shoulder girdle, low back, and hip girdle. •Spasticity – low back pain and limb pain caused by brain and spinal cord injuries •Sweating – Botox treatment can help control excessive sweating (hyperhidrosis) •Migraine – when the source of the migraine is the neck or facial muscles, injecting intramuscular Botox can help to relax the offending muscles for several months, thereby producing pain relief.

Preparing for the Procedure

No special preparation is needed. Bring a list of all current medications.

How is the Procedure Performed?

Botox® is injected into the affected muscle(s). WMP will determine which muscles need to be treated.

Does the injection hurt?

Some people report minor, temporary discomfort from the injection. Botox® is reconstituted with sterile, preservative-free, normal saline for injection. The neutral pH of the injected solution, in combination with the fine-gauge needle your doctor will use, can help to minimize any injection-related pain.

Follow-up after the Procedure

Possible Side Effects

  • The most frequently reported adverse reactions in patients receiving Botox® for the treatment of cervical dystonia are dysphagia (difficulty swallowing, 19%), upper respiratory infection (such as a cold or flu,12%), neck pain (11%), and headache (11%). Dysphagia is a commonly reported adverse event following treatment of cervical dystonia patients. In these patients, there are reports of rare cases of dysphagia serious enough to require the insertion of a gastric feeding tube (a tube for introducing nutritious, high-calorie fluids into the stomach.)
  • The most frequently reported treatment-related adverse reactions in patients receiving Botox® for the treatment of blepharospasm are ptosis (droopy eyelids, 20.8%), superficial punctuate keratitis (inflammation of the cornea characterized by small erosions of the tissue covering the cornea, 6.3%), and eye dryness (6.3%). Reduced blinking from Botox® injection of the orbicularis muscle can lead to corneal exposure, persistent epithelial defect (a defect in the corneal covering) and corneal ulceration (a hollowed-out cavity in the cornea), especially in patients with VII nerve disorders.
  • In general, adverse reactions occur within the first week following injection of Botox® and, while generally transient, may last several months. Localized pain, tenderness and/or bruising may be associated with the injection. Local weakness of the injected muscle(s) represents the expected pharmacological action of botulinum toxin. However, weakness of adjacent muscles may also occur due to spread of toxin.
  • Please seek immediate medical attention if swallowing, speech, or respiratory (breathing) disorders arise.

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