Can Botox make blepharospasms worse?

Question

I received Botox injections three weeks ago to relieve blepharospasms. The spasms have increased to the point I am now unable to drive and work. My eyes will not stay open due to the spasms forcing them shut and movement makes it worst. What would cause this?

Andrew Campbell, MD · Answer

I'm not sure how Botox could make the spasms worse since Botox is the treatment for spasms as it relaxes the muscle and prevents the muscle contraction. A personal evaluation would be necessary, so I'd recommend you see your injector and let them check you out. Maybe more Botox is needed in the spasmodic areas.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa Aesthetic Centers

Paul E. Goco, MD · Answer

Thanks for your question.  Botox when injected into the affected muscles will weaken the affected muscles. Please return to your injector. Additional muscles need to be injected to relieve your over active muscles. Good Luck.

Katrinka L. Heher, MD · Answer

While the Botox weakens the muscles and should improve the spasms, often it leads to worsening dry eye that causes the lids to close more. This usually occurs in the first 3-4 weeks after the injections.  I recommend that my patients aggressively lubricate their eyes during this period. Hopefully you will experience some relief over the next couple of months. Hope this helps and good luck.

Paul Blair, MD · Answer

It would be unlikely for that to occur.  I would call your injector and follow up with them.  Also, a second opinion can never hurt.

Christina Kim, MD · Answer

Botox is regarded as the most effective treatment of choice for the rapid but temporary relief of blepharospasm.  Once injected, it weakens the affected muscles (typically Orbicularis muscle) and relieves the spasm.  More importantly the effect of Botox is determined by the location of injection and the dose of medication.  If you are experiencing inability to stay open your eyes and forcing them shut and worsening of movement, it may be from adverse effect of Botox; most commonly, ptosis, is due to diffusion of Botox from the injection sites to the sensitive levator muscle.  I recommend you to check with your injector to find out what you are feeling is from inadequate relief of spasm or from adverse effect of injection.

Melvin Elson, MD · Answer

Botox is one of the best treatments for blepjarospasm so you should either return to your doctor or seek a second opinion

Can Botox make blepharospasms worse?

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