Botulinum Toxin (Botox®) Treatment

Botulinum toxin type A (often colloquially referred to as Botox®, one of the available products, the other being Dysport®) is a neurotoxin that in neurological practice is used to lessen abnormal muscle contractions. It is given by injections into muscles.

Botulinum toxin can only be used according to strict criteria. It may help in a range of neurological conditions including:

  • Chronic migraine
  • Spasticity as a result of stroke or cerebral palsy
  • Cervical dystonia / spasmodic torticollis
  • Hemifacial spasm
  • Blepharospasm
  • Hyperhidrosis (excessive sweating)

Please note that treatment for chronic migraine can only be used according to strict criteria:

  • Patients must be aged 18 years or over
  • Headaches have been present on average 15 or more days per month, 8 days of which are migraines, over a period of at least 6 months.
  • Three preventive medications have been unsuccessful, because of inadequate response, intolerability or contraindication.
  • Attempts have been made to reduce the overuse of acute medications, including analgesics (e.g. Panadeine forte, Mersyndol, Nurofen) or Triptans (e.g. Imigran, Zomig, Relpax, Naramig, Maxalt). This is defined as medication use more than 10 days per month

Treatment can be continued only if a 50% reduction in headache frequency is achieved after 2 treatment cycles of 12 weeks each.

What should I bring to the appointment and what should I expect?

You will need a referral from your doctor requesting assessment for consideration of Botulinum toxin treatment. One of our neurologists will first determine whether Botulinum toxin is appropriate for you. Depending upon your condition, Botulinum toxin may be given on the same day, or a follow-up appointment will be arranged to inject it on a different day. The initial appointment will take about 40 minutes and follow-up appointments about 20 minutes.

Botulinum toxin treatment for chronic migraine involves a total of up to 31 injections over the forehead, temples, back of the head, the neck and the shoulders. Botulinum toxin treatment of other neurological conditions involves fewer injections. Please do not wear makeup (foundation). If you have long hair, please bring a hair tie.