Botulinum toxin, commonly called Botox, is a purified protein that temporarily relaxes overactive muscles or reduces certain nerve signals. In neurology, it is used for chronic migraine, dystonia, muscle stiffness after stroke or in cerebral palsy, hemifacial spasm, eyelid spasm and excessive drooling.

At Apex, the neurologist decides whether injections are suitable after examining the affected muscles and reviewing previous treatments. The skin is cleaned, and tiny amounts are injected at carefully chosen sites using a very fine needle. In some conditions, EMG or ultrasound is used to guide placement. The injections take only a few minutes.

The effect is not immediate. It usually starts after several days and builds over about two weeks. It generally lasts for around three months, so repeat treatment is needed. Physiotherapy is often combined with injections for stiffness and spasticity.

How the Procedure Can Help

Injections can reduce muscle tightness, painful spasms and abnormal postures. In chronic migraine, they can lower the number of headache days in selected patients.

Risks and Considerations

Pain, bruising or tenderness at the injection site is common. Temporary weakness of nearby muscles, drooping of the eyelid or difficulty swallowing may occur. Patients with certain neuromuscular conditions or who are pregnant need individual advice. Trouble swallowing, breathing or speaking after injections needs urgent medical attention.