Botulinum toxin injection therapy (also known as “BOTOX® therapy” or onabotulinumtoxinA) has been studied for many years as a treatment for some neurological disorders. In 2010, the U.S. Food and Drug Administration (FDA) approved Botox for treatment of refractory, chronic migraine headache. Current best practices include use of Botox to treat chronic migraine in adults who experience headaches on 14 or more days each month. This treatment involves multiple injections in the head and neck, administered every 12 weeks. Botox is also used to treat a variety of other conditions including spasticity and dystonia, a condition that produces involuntary muscle contraction or spasm affecting muscles that control movement in the eyes, neck, face, limbs or elsewhere. The goal of the therapy is to reduce muscle spasm and pain.
Botox has proven benefit in the treatment of many forms of dystonia, including the following:
- blepharospasm–forceful involuntary closure of the eyelids
- hemifacial spasm–sudden contraction of the muscles on one side of the face
- torticollis or cervical dystonia–muscle spasm in the neck that causes the head to turn to one side, and sometimes forward or backward
- oromandibular dystonia–involuntary spasms of the face, jaw, neck, tongue and sometimes the larynx
- other focal dystonias (in the hand, e.g. writer’s cramp, arm or the leg)
- limb spasticity (e.g., following traumatic brain injury, MS or stroke)
As our neurons generate new nerve endings, dystonia tends to recur, requiring ongoing treatment. Generally, Botox is repeated every 3 to 4 months. For insurance to cover this service, prior authorization is generally required.