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Updated: Feb 12, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
UNILATERAL FRONTALIS MUSCLE PARALYSIS: MANAGEMENT WITH BOTULINUM TOXIN A (CASE REPORTS)
1Clinica Goldman, Porto Alegre, Rio Grande do Sul, Brazil; Department of Dermatology and Allergology, Municipal Hospital Dresden, Academic Teaching Hospital of the Technical University of Dresden, Germany.
Abstract:
Unilateral frontalis muscle palsy is a debilitating disease with a heterogeneous etiology. Congenital or acquired unilateral paralysis of the frontalis muscle causes ipsilateral brow ptosis and contralateral hypermobility of the non-paralytic frontalis muscle, resulting in a bizarre asymmetry and emotional embarrassment. We present five patients with unilateral frontal muscle paralysis, two males and three females, aged between 32 and 68, treated with botulinum toxin A injection to the contralateral (non-affected) side. A total dose between 10 to 30 U botulinum toxin A (onabotulinum or incobotulinum toxin A) successfully improve symmetry and facial esthetics without any adverse events. Botulinum toxin A is an alternative to facial palsy surgery but may also be used as an adjunct after the surgical procedure to optimize the outcome.
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