Leighton, There is absolutely no evidence that Botulinum Toxin A (BOTOX, Allergan, Inc, Irvine, CA) triggers Motor Neurone Disease. Motor Neurone Disease (MND) is a group of disease that are commonly referred to as ALS or Lou Gehrigs disease. It is in fact not clear what tiggers these conditions, although there is expanding information on the genetics of MND/ALS. The disease presents with progressive muscle atrophy, weakness, fasiculation or twitching and is assoicated with atrophy and cell loss in the ventral horns of the spine and corresponding loss of neurons in the brain. Emotional fluctuations and pathological laughter can be seen and this is referred to as a pseudobulbar palsy. BOTOX has been used to treat symptoms associate with MND and in this specific setting, some individuals can experience unwanted side effects of treatment related to the treatment. However, this is not the same thing and BOTOX causing their MND. Generally, it is advisable to avoid BOTOX cosmetic if there is a history of a neuromuscluar dengenerative illness. BOTOX may be recommended by a neurologist experienced with its use in these conditions to improve some of the symptoms of MND but this should not be confused with receiving BOTOX for cosmetic purposes. One has nothing to do with the other.