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Toxins 2017, 9(11), 352;

Neurophysiological Measures of Efficacy and Safety for Botulinum Toxin Injection in Facial and Bulbar Muscles: Special Considerations

Department of Medical Sciences, Uppsala University, 75185 Uppsala, Sweden
Department of Neuroscience, Clinical Neurophysiology, Uppsala University, 75185 Uppsala, Sweden
Author to whom correspondence should be addressed.
Academic Editors: Jennifer G. Goldman and Codrin Lungu
Received: 13 September 2017 / Revised: 16 October 2017 / Accepted: 27 October 2017 / Published: 30 October 2017
(This article belongs to the Special Issue Muscle Selection for BoNT)
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Botulinum toxin (BoNT) injections into facial and bulbar muscles are widely and increasingly used as medical treatments for cervical and facial dystonia, facial hemispasm, correction of facial palsy, hyperhidrosis, as well as cosmetic treatment of glabellar lines associated with grief and anger. Although BoNT treatment is generally considered safe, the diffusion of the toxin to surrounding muscles may result in complications, including difficulties swallowing, in a dose-dependent manner. The sensitivity of clinical examination for detecting adverse events after BoNT treatment is limited. Few reports have highlighted the potential effects on other muscles in the facial area due to the spreading of the toxin. The possibilities of spreading and thus unknown pharmacological BoNT effects in non-targeted muscles emphasise the importance of correct administration of BoNT in terms of dose selection, injection points, and appropriate effect surveillance. In this review article, we will focus on novel objective measures of efficacy and safety regarding BoNT treatment of facial muscles and the reasons why this is important. View Full-Text
Keywords: botulinum toxin; glabella; facial muscles; CMAP; diffusion botulinum toxin; glabella; facial muscles; CMAP; diffusion

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Alimohammadi, M.; Punga, A.R. Neurophysiological Measures of Efficacy and Safety for Botulinum Toxin Injection in Facial and Bulbar Muscles: Special Considerations. Toxins 2017, 9, 352.

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