How does botox work for facial palsy

There are different forms of facial palsy. When a nerve partially recovers after an injury, (Bell’s Palsy, Ramsay Hunt Syndrome or Acoustic Neuroma surgery) the signals it sends the facial muscles in abnormal. The muscles often tighten significantly and become 'spastic’. This abnormal signal also leads to uncoordinated movements called synkinesis.

In conjunction with physiotherapy from a fully trained facial therapist, chemodenervation with botulinum toxin (Botox and other drugs) can help relax the abnormally tightened or spasming muscle. When done carefully with accurate assessment this can improve the tight feeling in the face and allow the imbalances and uncoordinated movements to improve.

The drug wears off after about 3 months. Often people will want to continue their botox treatment regularly and some people find enough relief from one or two sessions to be able to maintain the improvement with physio.

The dose and location can take a few sessions to get right for each individual so it is important to make a diary at 4 weeks of what worked well and what didn’t.

Botox can be delivered by any experienced injector but the assessment of the facial palsy face is complex and most community injectors may not feel comfortable making a plan. The most effective botox is injecting the spasming muscles on the affected side. Occasionally a small amount for balance in the unaffected side is appropriate but this is not he main approach.

Unfortunately botox treatment in the private hospitals in New Zealand delivered by a surgeon is extremely expensive and usually not covered by health insurance despite best attempts and constant clarification that this is not cosmetic treatment. Emily can offer you an assessment and treatment plan to take to your preferred injector or refer you to the public hospital clinic she runs for publicly funded botulinum toxin injections to spasming facial muscles.