Botulinum Toxin for Movement Disorders

Botulinum toxin injections block nerve signals to muscles, causing them to relax. Although botulinum toxin is often used for cosmetic purposes, it can also be used to treat movement disorders, such as dystonia, hemifacial spasm, sialorrhea, and blepharospasm.

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What is Botulinum Toxin?

Botulinum toxin injections block nerve signals to muscles, causing them to relax. Although botulinum toxin is often used for cosmetic purposes, it can also be used to treat movement disorders, such as dystonia, hemifacial spasm, sialorrhea, and blepharospasm.

What are the forms of botulinum toxin?

• Botox^® or OnabotulinumtoxinA
• Myobloc or RimabotulinumtoxinB
• Dysport^® or AbobotulinumtoxinA
• Xeomin^® or IncobotulinumtoxinA
• Daxxify^® or DaxibotulinumtoxinA

Conditions we treat with botulinum toxin

• Bruxism (jaw clenching).
• Dystonia.
• Excessive salivation or sialorrhea.
• Eyelid closure dystonia or blepharospasms.
• Hemifacial spasm.
• Spasticity.
• Tics.
• Tremor.

Why Would I Need Botulinum Toxin for Movement Disorders?

You may need botulinum toxin if you have a movement disorder that causes involuntary muscle contractions or spasms.

Who’s a candidate for botulinum toxin for movement disorders?

You may be a candidate for this therapy if you have a movement disorder that has not responded to other treatments and is indicated for botulinum toxin treatment.

What kind of doctor gives botulinum toxin for movement disorders?

Movement disorder neurologists typically inject botulinum toxin for movement disorder indications.

Alternatives to botulinum toxin for movement disorders

• Medication — Such as muscle relaxers, anticholinergics, and benzodiazepines can be tried for certain cases.
• Surgery — Such as deep brain stimulation can be performed for some cases dystonia and tremor.

What Are the Risks and Complications of Botulinum Toxin for Movement Disorders?

Botulinum toxin is safe when given by a trained health care provider.

Side effects depend on the area where you received your injection and may include:

• Weakness.
• Drooping eyelids.
• Eye irritation or redness.
• Flu-like symptoms.
• Headache.
• Neck pain.
• Pain, swelling, or redness at the injection site.

What Should I Expect From Botulinum Toxin Injections for Movement Disorders?

Before: How to prepare for botulinum injections

Your doctor will explain the procedure to you and answer your questions.

To prepare for the procedure, you should:

• Tell your doctor if you are sensitive or allergic to any medications.
• Tell your doctor if you are pregnant, breastfeeding, or could be pregnant.
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have any other health conditions, such as myasthenia gravis. Your care team may need to take certain precautions during your procedure for your safety.
• Stop taking medications if directed by your provider. Do not stop taking any medications or change your medication routine without talking to your provider first.

You should be able to resume your normal activities immediately after your procedure.

How long does botulinum toxin for movement disorders take?

Botox for movement disorders is typically performed in your doctor’s office. The length of the procedure depends on how many injections you receive. Most procedures take less than an hour.

During your botulinum toxin injection for movement disorders

During the procedure, your doctor will:

• Ask you to lie down or sit in a chair.
• Some physicians may or may not use an electromyography (EMG) machine along with the injection, depending on where the muscles are located that need to be injected.
• Clean the area of your skin where you will receive the injection(s).
• Use a needle to inject the botulinum toxin into your muscle(s).

How painful are the injections for movement disorders?

Botulinum toxin injections use a very small needle and cause little to no discomfort, depending on your pain tolerance.

The medication can take three to five days or up to a week to start becoming effective. The goal of the medicine is to last up to three months. After your first round of injections, please record how long it took to kick in, when it wore off, and if you experienced any side effects and how long they lasted. This information is crucial to determining if the dosage given would need to be altered.

Will I need more Botox injections?

Because the effects of botulinum toxin injections are temporary, you will need repeated injections to manage symptoms. Your doctor will schedule another series of injections about three months after your last injection(s).

When to call your doctor about complications

 Call your provider immediately if you have:

• Difficulty swallowing.
• Nausea or vomiting.
• Numbness or paralysis in an area that has not been treated.
• Shortness of breath.
• Slurred speech.
• Vision changes or drooping eyelids.

What’s the success rate of botulinum toxin injections for movement disorders?

Many patients experience significant improvement in movement disorder symptoms after botulinum toxin injections. However, your expected success rate will depend on your condition and other factors.

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By UPMC Editorial Staff. Last reviewed on 2026-03-23.