Botox Treatment

Blepharospasm is an ocular condition wherein there is abnormal contraction or twitching of the eyelids. It is a neurological condition which is presented with forcible closure of the eyelids.

Hemifacial spasm is a condition in which there is reflexive or involuntary twitching or contracting movements of the muscles of the face, on one side (hemi/half) of the face. Hence, it is also referred to as “facial twitch”. These twitching movements are irregular and almost always limited to one side of the face as the name suggests. The eye on that side of the face gets involved in twitching (eyelid spasm).

Botox Treatment of Blepharospasm, Hemifacial Spasm & Meiges Disease:

• Botulinum Toxin Injections (Botox, Dysport, Neuronox as brand names) have been used to induce localized, partial paralysis of the eyelid closing muscle (orbicularis oculi), in both blepharospasm & hemifacial spasm. This is the gold standard of care

What is Botox?

• Botulinum toxin, or Botox, is a protein produced by the C. botulinum bacteria that leads to muscle paralysis by blocking the electrical messages that “tell” the muscle to move. Messages are conveyed by a neurotransmitter called acetycholine. Botox hinders the release of acetycholine; due to which, the muscle does not receive the message to contract & therefore the spasms & eyelid closure resolves.

Botox Injection Technique:

• A very fine needle is used to deliver 1 to 3 injections into your facial muscles. Botox usually works within three days and usually lasts for three months. Botox injections can be repeated indefinitely, however the effectiveness diminishes over the years due to the buildup of antibodies.
• Side effects of Botox Therapy include temporary facial weakness, drooping eyelid (droopy eyelid / eyelid ptosis), eye irritation and sensitivity.
  • Botox Injections are generally administered every three months, with variations based on patient response, and usually give relief within a week of symptoms from the eyelid muscle spasms. Most patients can resume a relatively normal life with regular Botulinum Toxin Injection.

  Sites for Botox Injections & Botox Injection Technique:

  Benign essential blepharospasm & the eyelid component of hemifacial spasm is treated with five injections, each consisting of 5 unit doses of Botox, injected subcutaneously at the medial and lateral aspect of each eyelid and at the lateral canthus. Total of 25-30 units per eyelid – Botox Injection Technique.

  Care should be taken to avoid injecting the mid portion of the upper lid in order to avoid paralyzing the levator palpebri superioris muscle and causing ptosis. In cases where the spasm spreads to other facial muscles and even to the neck, similar 2.5/ 5 unit injections are given subcutaneously at the site of the spasm i.e. Around the oral commissure (mouth), etc.

              Is Botox safe?

  Botulinum Toxin Injections have been used for more than 25 years on the face. Thousands of research papers have documented the safety of Botulinum toxin Injections. Botulinum Toxin (Botox) has got a safety profile which is actually better than many OTC (over the counter) medications (Botox is very safe), which patients use even without a prescription. The only thing is you must choose a doctor who has enough experience in using Botox around the eyelid area (best doctor for blepharospasm). When you realize that the eyelid is a very delicate structure, with muscle thickness in millimeters, you understand that this is an injection which must be administered by the specialist with immense experience in the same. This may be hard to understand for patients, since while a neurologist may diagnose you, the best person for eyelid & face injections of Botox may be a plastic surgeon, who deals with the facial anatomy on a daily basis.
  

  Botox Injection Price (Botox Injection Cost)

  The price of botox injections depends on the number of units of Botox injected, which in turn depends on the intensity of the blepharospasm / hemifacial spasm (severity of disease). Cost of Botox varies from Rs. 250 per unit to Rs. 700 per unit of Botox injected, in India – Approximately USD 4 to USD 12 per unit of Botulinum Toxin injected. This is much cheaper than the price of Botox in the developed world, approximately 1/3^rd the cost of Botox injections in the USA or UK. You must remember to ensure that you are charged only for the amount of Botulinum Toxin that is used in you & not for the whole vial of the Botox.

  To read more on Botox Injections Treatment for benign essential blepharospasm, hemifacial spasm & meiges disease, read this blogpost by Dr. Debraj Shome:

  http://debrajshome.wordpress.com/2013/07/20/best-treatment-blepharospasm-botox-injection/

  Watch a patient with Hemifacial Spasm treated with Botox Injection by Dr. Debraj Shome: