Hello and thank you for your question. I am sorry you are having to deal with this painful condition. Although I have not had to treat a patient with First Bite Syndrome with Botox, the medical literature does have a number of studies and case reports of Botox or other neuromodulators being a helpful treatment, albeit to decrease the sensation, not necessarily to create no sensation. The dose range seems to vary and I suspect it would be a trial and error approach as to how much you would need (I would probably start with 50 units, with injections spaced throughout the parotid gland and a few more concentrated in the region of maximal pain). I would recommend that you see a facial plastic surgeon (or an ENT specialist who provides Botox treatments) to do the treatments. Facial plastic surgeons initially train as ENT specialists and then go on to do further subspecialty training in facial plastic and reconstructive surgery. They are also almost certainly providing Botox in their offices for cosmetic reasons so very familiar with Botox. The training and experience in ENT disorders would give you the best chance of a successful treatment as it is important to target the parotid gland (and not the masseter muscle, which is not the problem in First Bite Syndrome). I would also comment that First Bite Syndrome is not a neuropathic pain disorder (suggested below).
