Related Experiment Video
Updated: Apr 16, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Regional diffusion of botulinum toxin in facial muscles: a randomised double-blind study and a consideration for
Anna Rostedt Punga1, Annika Eriksson, Mohammad Alimohammadi
1Department of Clinical Neurophysiology, Uppsala University, Uppsala, Sweden.
Abstract:
Despite the extensive use of botulinum toxin A (BoNTA) in medical and cosmetic treatments, the potential spreading of BoNTA to surrounding tissues remains unknown. A patient with hemifacial paralysis upon blepharospasm treatment with low dose of BoNTA, prompted us to investigate the spreading effect. A randomised, double-blind study was conducted in which 5 healthy women (33-52 years) were treated with different doses of onabotulinum toxin unilaterally in the corrugator muscle. Parameters of efficacy and diffusion (CMAP; EMG and jitter analysis) in both glabellar and frontalis muscles were assessed at baseline, 2 and 4 weeks following BoNTA injection. CMAP of the treated glabellar muscles was reduced to approximately 40% in all dose groups. Additionally, contralateral CMAP reduction was observed in 3 of 5 subjects. These data confirm regional diffusion of BoNTA in facial muscle application, which raises question on the reliability of split-face models in BoNTA studies.
Related Concept Videos
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
The binding of dantrolene to the RYR1...
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Skeletal Muscle Relaxants: Therapeutic Uses
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Although all competitive neuromuscular blockers are designed...
Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...

