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Updated: Jul 16, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Low-dose subcutaneous injection of botulinum toxin type A for facial synkinesis and hyperlacrimation
1Department of Neurology, Tokyo-West Tokushukai Hospital, Akishima, Tokyo, Japan. hishashi.ito@tokushukai.jp
Objective:
To investigate the efficacy of low dose of botulinum toxin type A (BTX-A) for facial synkinesis and hyperlacrimation.
Material And Methods:
Eleven patients suffering from facial synkinesis after Bell's palsy or facial nerve injury were treated with a low dose of BTX-A, 0.5-1.25 U per point into several points. One patient showing hyperlacrimation was also treated with BTX-A. The whole observational period was 43 months.
Results:
On average, 5.76 U of BTX-A, which was lower than that of previous reports, was injected per treatment. In seven cases, synkinesis disappeared completely after three or fewer sessions of BTX-A injection. The mean interval between treatments was 14.5 weeks. Hyperlacrimation was completely suppressed after a single subcutaneous injection of BTX-A. Only mild subcutaneous hemorrhage was observed as adverse reactions.
Conclusion:
Facial synkinesis can be treated with a lower dose of BTX-A without relevant adverse reactions.
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