Botox treatments for Meige syndrome but is it safe with an undiagnosed condition, possibly lyme disease?

Question

Im a male whos been dealng with a mysterious condition for 26 yrs that could possibly be lyme disease even though unreliable tests have come back negative. Is it safe to get botox for my blepharospasm dystonia & meige syndrome whic i suspect could have been induced by possible lyme ?

Anna Chacon, MD, FAAD · Answer

I understand why you would be cautious, especially after dealing with unexplained symptoms for so many years. When you have a possible underlying neurologic condition, it is reasonable to wonder whether Botox could make things worse.

The good news is that a history of possible Lyme disease, by itself, is not a contraindication to Botox. Botox is an established treatment for blepharospasm, and botulinum toxin is also commonly used to reduce the involuntary muscle contractions associated with Meige syndrome.

The part that deserves more caution is the undiagnosed neurologic condition itself. Botox temporarily weakens the muscles into which it is injected. The prescribing information specifically warns that people with underlying neuromuscular disorders can have a greater risk of generalized weakness, drooping, double vision, difficulty speaking or swallowing, and, rarely, breathing problems.

So I would separate the two questions:

1. Could Lyme disease itself make Botox unsafe?
Not necessarily. Lyme disease is not listed as a contraindication to Botox. Neurologic Lyme disease can, however, cause problems involving the facial nerves, peripheral nerves, and occasionally the central nervous system. Symptoms can include facial weakness, numbness, tingling, nerve pain, or weakness.

2. Should an unexplained neurologic condition be clarified before Botox?
If you have significant or progressive weakness, facial paralysis rather than spasms, difficulty swallowing or breathing, widespread muscle weakness, or other concerning neurologic symptoms, I would want those issues evaluated carefully before proceeding with Botox. That is because the concern is the underlying neuromuscular condition, rather than Lyme disease specifically.

Regarding your negative Lyme tests, it is also important not to assume that every negative test is unreliable. The CDC recommends FDA-cleared two-step antibody testing, and the interpretation depends on timing, exposure history, symptoms, and the type of test performed. False-negative results are most concerning early in infection, before enough antibodies have developed.

After 26 years of symptoms, however, the situation is different from someone who was tested shortly after a recent tick exposure. At that point, the diagnosis should be approached broadly rather than attributing the blepharospasm or Meige syndrome to Lyme disease without supporting clinical evidence.

For someone with established blepharospasm/Meige syndrome and no evidence of a significant neuromuscular disorder, Botox can be a very reasonable treatment. The injections are carefully targeted to the muscles producing the spasms, and the dose can be adjusted based on your response and side effects.

My biggest concern would not be the possibility of Lyme disease alone—it would be making sure there isn't another neurologic or neuromuscular disorder that could increase your risk from botulinum toxin. I would also avoid assuming that Lyme disease is the cause of a 26-year neurologic condition solely because other testing has been negative or inconclusive. A careful neurologic evaluation is important in that situation.

Botox treatments for Meige syndrome but is it safe with an undiagnosed condition, possibly lyme disease?

Answers (1)

More Botox Questions

Will botox help with the indentation above my eyebrows due to years of frowning? (Photo)

Would Masseter Botox, FaceTite, or fillers help to contour cheeks? (Photos)

Would Botox address facial asymmetry? Is there a more permanent option? (Photos)

Worsening glabellar shadow for 2 years, what is this and how can I treat it? (Photos)

How can I treat the hooks above nostrils nasalis or labii superioris alaeque nasi? (Photos)

Can forehead botox cause an indentation on the hairline? (Photo)

WE SEND PRETTY
EMAILS