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, Botox and Neurobloc.

  • How does it work?

    Botulinum toxin reduces muscle contraction which reduces stiffness or tone within individual muscles.

  • How is it given?

    Botulinum Toxin is given by injection into the muscle, or group of muscles with a very fine needle.

  • How long will it take to work?

    The toxin takes up to two weeks to be effective after an injection and can last up to six months.

  • How often will I need treatment?

    This depends upon how you respond to treatment. Injections can be repeated every 3-4 months as needed, providing it is not within eight weeks of your last injection for Dystonia and 12 weeks of your last injection for Spasticity.

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

  • Benefits of treatment

    • The toxin reduces the stiffness and strength in those muscles injected.
    • For people who have spasticity it may allow greater movement and flexibility over the affected limb.
    • For people who have spasticity it may allow greater passive movement of the muscle. Individual goals will be discussed at your appointment.

  • Considerations for treatment

    Botulinum toxin
    This product is manufactured using components taken from human blood.

    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. Recent INR (international normalized ratio) levels must not be above 3.

    If you are pregnant, breast feeding or trying for a baby.

  • Doses

    The dose will vary according to your needs. The dose may vary as changes in your symptoms occur.

    The site of injections may vary according to your needs.

  • Side effects

    On rare occasions there have been complaints of flu-like symptoms such as headaches, fever and feeling tired. These symptoms are minor and do not last for long. With injections into the neck approximately 10% of cases experience a short lasting difficulty with swallowing.

    With injections around eyes there may be a transient problem e.g. double vision, blurred vision and drooping of eyelid.

    With injections for spasticity possible side effects are muscle weakness, reactions at the injection site including pain, and haematoma (a localised collection of blood).

    All side effects are temporary. There is also a risk of widespread muscle weakness, allergic reaction and breathing/swallowing problems, however these are rare. Fatalities are 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 any of the above side effects please contact the Neuro Rehabilitation Outpatient Department, Monday-Friday 9am-4.30pm. Out of hours contact your GP or casualty department. In an emergency ring 999.

  • Consent

    Signed consent form is required before the 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:
    • talk to the people directly involved in your care
    • ask a member of staff for a feedback form, or complete a form on the Trust website (click on the ‘Contact Us’ tab)
    • telephone the Complaints Department 0191 245 6672
    • email Please note that information sent to the Trust via email is sent at your own risk
    • 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 from staff.

  • 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
    2017 Copyright, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
    Ref, PIC/110/1220 December 2020 V8 Tel: 0191 246 7288
    Review date 2023