Botulinum Toxin

Clinical Indications (currently accepted and/or under study)


Strabismus                                           Lower  lid entropion

Aquired Nystagmus                               Thyroid  ophthalmopathy

Dwayne's syndrome                              Oscillopsia

Apaxia of eye lid opening                       Hyper-lacrimation

Movement Disorders

Myoclonus                                           Hemi-facial spasm   

Palatal myoclonus                                 Myokymia    

Focal Dystonias

Blepharospasm, Meige  syndrome, oromandibular dystonia, cervical dystonia, laryngeal dystonia, truncal dystonia, limb dystonia, Task specific dystonia.

Tics, Tourette's syndrome.  

Tremor (Essential tremor, Parkinson's tremor, hereditary chin tremor).

Synkinesia Post Bell's Palsy,

Tardive disorders,   

Rigid akinetic syndromes

Parkinson's, Progressive supranuclear palsy, Hallovorden Spatz, Stiff  person syndrome

Rehab Medicine

Disorders related to muscular compression of normal anatomy

Thoracic outlet syndrome.

Disorders of Painful Muscular Spasm

Spasticity: Post stroke, Cerebral Palsy, Multiple sclerosis

Back pain

Muscular tension headache

Focal myofascial pain TMJ associated muscle spasm

Plastic Surgery

"Hyperactive muscles of facial expression" (wrinkles)

Maseter hypertrophy

Facial asymmetry (post Bells)

Muscle flap paralysis during healing


Vocal cord polyps                                          Stuttering

Vasomotor rhinitis                                 Hypersalivation


Detrusor – sphincter dyssynergia              Vaginismus


Cricopharyngeal spasms                         Achalasia

Anismus                                              Rectal fissures


Fracture stabilization (eg Jaw)



 "Hyperactive muscles of facial expression" (wrinkles)

 Hyperhydrosis (excess sweating)