Can the trigeminal nerve absorb Botox and still heal?

Question

It’s been 4 months and I can’t voluntarily keep my eyelids closed. 30 yo female got Botox for TMJ in April 2021. The nurse recommended I also inject my crows feet area for eye strain. The next night, I could blink but COULDN’T keep my eyes closed (lagophthalmos). Drs think the nurse injected my (R) trigeminal nerve, not muscle, which is why my (R)throat is numb and (R)ear can't stabilize. BUT, no one can explain why I can’t keep my eyelids closed. Do nerves absorb Botox? I know Botox is “temporary” but is the damage permanent? Is this a nerve or muscle issue?

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the difficulties you're experiencing. Here's some information that might help you understand the situation better:

Botox Mechanism:
Botox works by temporarily blocking nerve signals to muscles, which prevents them from contracting. It's typically used to target muscles, not nerves directly.

Nerve vs. Muscle Effects:
Botox does not absorb into nerves; it acts at the neuromuscular junction where nerves meet muscles. The symptoms you're describing, such as difficulty keeping your eyelids closed and numbness, suggest that the Botox might have affected surrounding muscles or inadvertently impacted nerve function due to its spread.

Lagophthalmos and Eye Closure:
Difficulty in keeping your eyes closed (lagophthalmos) can occur if Botox affects the orbicularis oculi muscle, which is responsible for closing the eyelids. This is typically a muscle-related issue.

Recovery and Healing:
Botox effects are temporary, usually lasting 3-6 months. Most side effects resolve as the Botox wears off, allowing nerve and muscle function to return to baseline. However, recovery can vary based on individual responses and the exact placement of the injection.

Consultation with a Specialist:
It's important to consult with a neurologist or an oculoplastic surgeon who can evaluate your symptoms and provide a more detailed assessment. They can help determine if further intervention is needed and monitor your recovery process.

Potential Treatments:
In some cases, physical therapy or specific eye exercises might be recommended to help regain muscle function and improve symptoms.

While Botox-related complications are generally temporary, ongoing symptoms should be evaluated by a healthcare professional to ensure proper management and recovery.

Can the trigeminal nerve absorb Botox and still heal?

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Can the trigeminal nerve absorb Botox and still heal?

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