Botulinum Toxin Injections for the Treatment of Neurological and Movement Disorders

Botulinum toxin (BoNT) is a protein and neurotoxin which is extremely effective in treating certain neurological and movement disorders. BoNT injections are used to treat disabling pain, varieties of dystonia, abnormal movement disorders and autonomic nervous system. 

Symptoms of neurological conditions

  • Pain
    • Chronic daily headaches, including chronic migraine headache or chronic tension headache
    • Myofascial (tissues covering and connecting muscles), neck or back pain
  • Movement disorders
    • Blepharospasm (eyelid twitches)
    • Hemifacial spasm (twitches on one half of the face)
    • Oromandibular dystonia (contractions of the mouth, jaw and tongue muscles)
    • Cervical dystonia (contractions of the neck muscles)
    • Truncal dystonia (contractions of the torso muscles)
    • Hand or foot dystonia
    • Refractory tremor (persistent and uncontrollable shaking) 
    • Palatal tremor (shaking of the rear roof of the mouth)
    • Tics, Myoclonus (brief, involuntary twitching of the muscles)
  • Spasticity (stiff or rigid muscles)
  • Bruxism (teeth grinding)
  • Hyperhidrosis (excessive sweating, especially of the armpits, palms and soles) 
  • Hypersalivation or Sialorrhea (excessive production of saliva)

How BoNT works

BoNT works by blocking unwanted transmissions from being sent along the nervous system by preventing an organic compound called acetylcholine from being released. This reduces the volume of transmissions passing the point where the nervous system connects with the muscle system connect and reaching the body’s pain receptors and involuntary nervous system.

Risk Factors

  • Pregnancy: Studies on animals show adverse effects on the fetus but no controlled tests have been conducted on humans.
  • Lactation: Safety unknown due to insufficient data
  • Drug interaction: Can cause negative reactions if taken at the same time as some antibiotics ( aminoglycosides), malaria medication (Chloroquine), and neuromuscular blocking agents
  • Neuromuscular disorders: Can cause a muscle weakening condition known as myasthenia gravis

Common side effects from:

  • Facial injection to treat hemifacial spasm, eyelid twitching, chronic daily headache, facial tics, teeth grinding, or hypersalivation
    • Bruising 
    • Drooping eyelid 
    • Blurred vision, double vision 
    • Facial weakness
    • Dry mouth
  • Neck injection to treat neck muscle contractions or neck pain
    • Pain at the point of injection
    • Local muscle weakness
    • Difficulty swallowing
    • Dry mouth, hoarse voice 
  • Limb and body injection to treat muscle contractions, twitching, or shaking
    • Local muscle weakness 
  • General usage
    • The toxin may spread beyond the injected area, causing difficulty with swallowing or breathing. The risks increase when BoNT is injected into children, used in high doses or injected into the wrong muscles.


  • Always consult a specialist before receiving this treatment
  • Report any side effects to your doctor immediately


Neuroscience Center
Bumrungrad International Clinic (BIC) Building, 19th floor
Bumrungrad International Hospital, Bangkok, Thailand

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