Can hyaluronidase cause permanent nerve damage or paralysis when injected into the lips?

Hyaluronidase most certainly will not cause nerve damage. Now it is possible that the needle used to inject the hyaluronidase can hit or pierce a nerve which can cause a bruised nerve and temporary problems.

Any movement problems or nerve injury are not related to hyaluronidase. This is impossible. What is possible is that Botox or Dysport which was injected to an area nearby the hyaluronidase spread more than usual and caused this. This would lead to only temporary problems too. The small vial of Botox and the Dysport vials are similar in size to Hylenex and it is possible that the injector might have interchanged the 2 as well.