The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.


Botox, the best known form of Botulinum toxin, has been increasingly used in Neurology practice since its first approval by FDA in 1989. In addition to its popular role for cosmetic purpose, it has been used in multiple neurological conditions including: migraine; tension headache; tilted neck (torticollis or cervical dystonia); chronic neck and back pain; facial and eye lid twitches (facial and blepharospasms); limb spasticity after stroke, cerebral palsy, multiple sclerosis or spinal cord lesions; hyperhydrosis; temple-mandibular joint dysfunction (TMJ) and tremors.

Botox works by blocking the neurotransmitter release from nerve endings to muscle, allowing the muscle to relax. As a result, abnormal movements or muscle contractions are decreased.

Individual response to Botox treatment varies. Overall the treatment success rate is very high and majority of patients who receive this treatment are pleased with the benefit. But it is not a cure. On average, its effects last about 3 months and frequently repeat treatment is required.


Botox treatment is not without side effects, but they are extremely rare and transient. After long term use of Botox, there is a slight chance developing resistance and the treatment appears less effective. The other widely used Botulinum Toxin is Myobloc, which is equally effective and it has special value in patients who developed resistance to Botox.

For torticollis, spasticity, and other dystonias, most insurances including Medicare cover the treatment. For other indications, it varies and frequently a pre-authorization from the insurance company is needed. This question can be addressed during consultation in our Botox Clinic.