Botox – famous for smoothing out wrinkles on the face – long has been used by neurologists for treatment of involuntary movements. These movements include dystonias, such as torticollis or “writer’s cramp”, hemifacial spasm, blepharospasm, and spasticity. When localization is challenging, we perform injections under EMG guidance. Treatment effect usually starts several days after the injection, and, because the drug wears off, treatment must be repeated every 3 months.
If you are having facial injections, you should, unless medically necessary, avoid taking aspirin, advil, or other anti-inflammatory medicine for sat least 5 days before the procedure.