Botulinum Toxin Injections – Walkergate Park

Information about botulinum toxin, how it works, how it's given, benefits and side effects.

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  • What is Botulinum Toxin?

    Botulinum Toxin is a naturally occurring substance, made from bacteria. There are numerous brands of Botulinum Toxin; we currently use Xeomin as our first line product but we also use Dysport and Botox.

  • What does it do?

    Botulinum Toxin is a muscle relaxant, reducing muscle overactivity/contractions.

  • How is it given?

    Botulinum Toxin is given by injection (using very fine needles) into the muscle/group of muscles.

  • How long will it take to work?

    The toxin takes up to two weeks to be effective after the injection is given, usually between 4-7 days.

  • How often will I need treatment?

    The effects are temporary. Depending on how you respond to treatment injections are usually every 3-4 months, occasionally longer.

    You may be asked to complete a questionnaire to record the effects of the injections.

  • Benefits of treatment

    Botulinum Toxin relaxes the muscles that have been injected reducing the overactivity of the muscles. This may result in the following:

    • Reduction in involuntary movements
    • Ease of passive/active dressing and personal care
    • Ease of hand hygiene/care/splint application
    • Associated pain relief

    Individual goals of treatment will be discussed at your appointment.

  • Considerations for treatment

    If you have been prescribed antibiotics and/or are feeling unwell there is a risk that the injections (if given) are not effective and therefore you may not be given the injections. A further appointment will be arranged if this is the case.

    People receiving anticoagulants, medication to thin the blood e.g. Warfarin, may not be suitable for treatment. This is not an absolute contra-indication. Please bring your anticoagulant book with you to your appointment. An INR (International normalised ratio) level needs to be below 3 and taken within 48 hours of your appointment.

    Pregnancy and breastfeeding
    Currently there is limited evidence to support the use of Botulinum Toxin injections if you are pregnant or breastfeeding. If you are trying to become pregnant, are pregnant or breastfeeding other ways of managing your condition will be discussed during the appointment.

    Botulinum toxin is manufactured using components taken from human blood, people of some faiths may not wish to have Botulinum Toxin injections.

    CNTW are advising a precautionary gap of seven days either side of Covid vaccinations before proceeding with Botulinum Toxin injections.

    The dose will vary according to your needs. The dose may vary as your symptoms change.
    The site of injections may vary according to your needs.

  • Side effects

    The side effects are generally temporary, and may include the following:

    • Flu type symptoms (headaches/fever/tiredness) following injections
    • Pain over the injection site
    • Infection near the injection site
    • Haematoma (bruising) over the injection site
    • Skin reaction around the injection site
    • Swallowing difficulties
    • Over weakening of the muscles
    • Widespread muscle weakness (systemic)
    • Anaphylactic reaction (severe allergic reaction)
    • Respiratory/breathing difficulties
    • Fatality (very rare, fewer than 1 in 10,000)

    Your clinician will discuss all relevant side effects with you at your appointment.

  • Who to contact if you develop side effects

    If you develop side effects please contact the Neuro-Rehabilitation Outpatient Department. Tel: 0191 287 5100, Monday to Friday; 8.30am – 4.30pm

    Out of hours contact your GP or call 111

    In an emergency call 999

  • Consent

    A signed consent form is required before administration of Botulinum Toxin injections. This consent is only required once.

  • Further information

    If you don’t understand any part of this leaflet or have any further queries please contact the Outpatient Department, Walkergate Park.  Telephone: 0191 287 5100

  • References

    A full list of references is available on request from the Patient Information Centre,
    Tel: 0191 246 7288

  • What if I have a comment, suggestion, compliment or complaint about the service?

    If you want to make a comment, suggestion, compliment or complaint you can:

    We are always looking at ways to improve services. Your feedback allows us to monitor the quality of our services and act upon issues that you bring to our attention. You can provide feedback in the following ways:

    • the quickest way for you to do this is to complete our short online survey at
    • complete a Points of You survey, available on wards, reception areas or from staff
    • other options for sharing your feedback and experience

    Patient Advice and Liaison Service (PALS)
    PALS provide confidential advice and support, helping you to sort out any concerns that you may have about any aspect of your or your loved ones care.

    We act independently when handling patient and family concerns, liaising with staff, managers and, where appropriate, relevant organisations, to negotiate prompt solutions. If necessary, we can also refer patients and families to specific local or national-based support agencies.

    North of Tyne
    Tel: 0800 032 0202
    Email: [email protected]

    South of Tyne
    Tel: 0800 328 4397
    Text: 07825 061 035
    Email: [email protected]
    Post: Patient Advice and Liaison Service, Garden Lodge, Hopewood Park, Ryhope, Sunderland, SR2 0NB

    9am – 4.30 pm, Monday to Friday
    An answerphone is available at all times for you to leave a message. A member of the PALS team will aim to return your call as soon as possible.

  • Information about content, other formats and version control

    Further information about the content, reference sources or production of this leaflet can be obtained from the Patient Information Centre. If you would like to tell us what you think about this leaflet please get in touch.

    This information can be made available in a range of formats on request (eg Braille, audio, larger print, easy read, BSL or other languages). Please contact the Patient Information Centre Tel: 0191 246 7288

    Published by the Patient Information Centre
    2024 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/110/0124 January 2024 V9 Tel: 0191 246 7288
    Review date 2027