Fortunately, the Botox wears off in 4-6 months. Suite 101 Hence, Botulinum toxinrelaxes muscles which are too tight and can prevent involuntary facial movements, or synkinesis. If you do use this drug, your doctor may want to monitor you more closely during your treatment. Learn about its symptoms, diagnosis, treatment, and outlook. If a patient is allergic to botulinum toxin or other ingredients in Botox, he or she may be ineligible for Botox injections. Botox lasts 3-6 months, at which time we will see patients back to re-administer the medication and titrate the doses and muscles targeted, as necessary. Facial paralysis due to other causes may benefit from surgery to repair or replace damaged nerves or muscles, or to remove tumors. Use tab to navigate through the menu items. Genetic and metabolic factors may contribute to the longevity of Botox, but there is nothing you can really do to increase longevity. If youre taking Botox to treat a bladder problem, you shouldnt receive injections if you have a UTI. The changes in brain remapping are dose-dependent: the more you use, the bigger the effect. You should avoid rubbing or massaging the area where you had the injections for a few days after receiving Botox. And some may be easily managed, too. They physically change in response to a number of external inputs. You may need treatment in a hospital. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. What is the outlook for facial paralysis? You can ask your pharmacist to recommend a medication thats safe for you. You shouldnt drive if you have symptoms such as blurred or double vision, drooping eyelid, dizziness, or muscle weakness. But these studies only involved children who were already using a catheter to empty their bladder. In doing so, Dr. Azizzadeh ensures that a patient knows exactly what to expect throughout all stages of a Botox treatment. Your email address will not be published. calcium While facial paralysis is often alarming, it does not always mean that you are having a stroke. If youre pregnant or breastfeeding, or are planning to become pregnant or to breastfeed, talk with your doctor about whether Botox is right for you. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The Facial Paralysis Institute offers Botox for permanent Bells palsy treatments that have been shown to relax unwanted muscle movements on the normal side of the face. Upper respiratory infections are the most common side effect in children who use Botox for this condition. Massive Stroke: Symptoms, Treatments, and Outlook . [This column was updated on 3/5/19.] Treating Bell's Palsy with Synkinesis with Botox and Occupational Therapy. It blocks nerve signals to facial muscles. Everyone's face is asymmetrical. But this doesnt affect the brain. . He will also respond to a patients treatment concerns and questions and ensure a patient can make an informed treatment decision. massager If youre concerned about Botoxs effects on your brain, talk with your doctor. Allergan Inc (2022): Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Possible long-term side effects of Botox include: If youre concerned about possible long-term side effects with Botox, talk with your doctor. The current explanation for this counterintuitive observation is that the limited paralysis caused by Botox deprives the brain of sensory inputs normally generated by forehead and facial. A Botox treatment for permanent or longstanding Bell's palsy is available to help patients mitigate the effects of unilateral facial weakness. Bell's palsy, on the other hand, is induced by an inflamed facial nerve, which causes edema (swelling) and inhibits the nerve from interacting with the brain as well as facial muscles to make appropriate facial movements. Selective neurolysis is the most advanced surgical option to treat facial paralysis. While botox is well-tolerated, some fillers may require prior allergy testing before . Retrieved from. Therefore if the cause is a stroke, the forehead will still move on both sides. But in these studies, children receiving Botox for this condition were already regularly using a catheter to empty their bladder. During selective neurolysis, Dr. Azizzadeh releases the platysma muscle and decreases nerve activity in the nerves that counteract the smile mechanism so that the mouth can once again turn upward, restoring the patients ability to smile. Common causes of facial paralysis include: Facial paralysis can come on suddenly (in the case of Bells palsy, for example) or happen gradually over a period of months (in the case of a head or neck tumor). Like other drugs, Botox can cause mild or serious side effects. Use of Botox can help decrease involuntary facial movements (aka synkinesis) and other signs of facial paralysis. As such, when parotid tumors are surgically removed, the facial nerve may be damaged or cut. doctor Symptoms of injection site reactions can include: Injection site reactions typically develop in the week after receiving injections. Dr. Azizzadeh and a patient together will monitor Botox treatment results over time. Acoustic neuromas (Vestibular schwannomas), Facial paralysis after head and neck surgery, Facial paralysis after ear infection or ear surgery, Depressor labii inferioris (DLI) excision, Masseteric Facial Nerve Transfer (V-VII Transfer), Hypoglossal Facial Nerve Transfer (XII-VII Transfer). This will help avoid spreading the toxin into other areas. A common cause of facial nerve paralysis is Bell's Palsy- temporary paralysis or weakness of the muscles on one side of the face. A Botox treatment for permanent or longstanding Bells palsy is available to help patients mitigate the effects of unilateral facial weakness. The clinical syndrome of botulism, which is often lethal, typically occurs from either a wound infection or eating undercooked or improperly canned food. Dr. Azizzadehs goal is to provide a patient with a safe, effective treatment to address his or her facial paralysis symptoms. The most common side effect is drooping eyelid. Biceps tendinitis is a painful condition, but it can be treated, and sometimes taping helps. We will then schedule patients to come in for a Botox visit. Mild side effects in adults using Botox for migraine include: Mild side effects in people using Botox for axillary hyperhidrosis include: Mild side effects in people using Botox for limb spasticity include: Mild side effects in people using Botox for cervical dystonia include: Mild side effects in people taking Botox for blepharospasm include: Mild side effects in people using Botox for strabismus include: Mild side effects in people using Botox for bladder problems include: In most cases, these side effects should be temporary. physiotherapy To learn more about the drugs use for cosmetic reasons, check out this article. Bells palsy causes temporary weakness or paralysis of the facial muscles. Facial paralysis occurs during a stroke when nerves that control the muscles in the face are damaged in the brain. Botox is most commonly utilized with neuromuscular retraining that will be performed by an experienced physical therapist. If I get side effects with Botox, should I stop getting the injections? And paralysis causes atrophy. Signals from brain not able to reach to the muscles. It is essential to meet with a Dr. Azizzadeh before undergoing Botox treatment for Bells palsy. Physical therapy can also help strengthen your muscles and prevent permanent damage. 984-974-2255. Sorry to hear that you're not happy with your results. For these people, physical therapy and eye care can help prevent any further damage and improve quality of life. What are the common side effects of Botox? If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. Any surprise here? Perhaps your Botox hasn't worn off completely and you are feeling some residual effects. Examples of these medications include certain antibiotics, anticholinergics, muscle relaxers, and drugs that block nerve signals to your muscles. Check out the before and after photos below to see how Botox treatments have helped many Bells palsy patients rejuvenate their facial appearance. Botox (also known as botulinum toxin) is a well-studied medication with a large number of applications. We often recommend three or four physical therapy sessions PRIOR to Botox to help patients learn to use their facial muscles better before weakening certain muscles. Botox (onabotulinumtoxinA) for injection, for intramuscular, intradetrusor, or intradermal use. Botox can sometimes spread from the area where its injected and cause trouble breathing or swallowing. Differential diagnosis: Bells palsy vs. stroke, Mayo Clinic Staff. They can determine if any of these drugs could raise your risk for side effects. Keep reading to learn more. Regardless of facial paralysis symptoms, Dr. Azizzadehs approach to treatment remains the same. The Injection of Botox to reduce facial lines and wrinkles has long been assumed to be purely cosmetic in nature. We herein report a case of left hemifacial spasm (HFS) developed ipsilateral facial nerve palsy 5 days after botulinum toxin type A (BTX-A) injection. Botox which will improve with ice and time. If the stroke happened too long ago for this treatment, the doctor may treat you with medications to reduce risk of further brain damage. Botox can cause a host of medical conditions. At the Facial Nerve Center, we are experts in identifying the facial and neck muscles where Botulinum toxin can be administered to improve facial symmetry, improve a patients smile, decrease synkinesis, and relieve tightness. For those who dont recover fully, cosmetic surgery can help correct eyelids that wont fully close or a crooked smile. Most of our patients return for a follow-up treatment at 4 months on average. This suggests that the cortical reorganization to Botox facial paralysis is intrinsically different from that observed after functional loss from amputations, facial nerve injury, or stroke. In . The most common use of these injections is to temporarily relax the facial muscles that cause wrinkles in the forehead and around the eyes. Therefore, a Bells palsy patient should meet with Dr. Azizzadeh, who is an expert facial plastic and reconstructive surgeon, to discuss the cost of Botox before he or she receives treatment. Its also not known if Botox passes into breast milk, or whether it can affect a child who is breastfed. In studies, side effects of Botox in children with blepharospasm or strabismus were similar to those seen in adults who used Botox for these conditions. Medically reviewed by Philip Thornton, DipPharm. It's a facial nerve disorder that causes sudden paralysis or weakness of the facial muscles on one side of the face. Below are some of the more common side effects reported by people who used Botox in studies. Cognitive behavioral therapy Swallowing and breathing difficulties can be life threatening and there have been reports of death. Among patients with restrictive lung disease of neuromuscular aetiology and detrusor overactivity associated with a neurologic condition, the event rate of decreased forced vital capacity (FVC) of 15% or 20% or more was also greater in treated patients compared with placebo. Ubrelvy, Gemtesa, propranolol, diclofenac, atenolol, baclofen, topiramate, nifedipine, celecoxib, oxybutynin. How Do Gifted Adolescents See Themselves? While the Botox we use for facial palsy is the same medication that is used for cosmetic purposes (to decrease wrinkling with facial movement), insurance will typically cover Botox use for patients with facial palsy. Talk with your doctor about whether this treatment is right for you. It can be lethal in large doses. You may need a temporary catheter to help empty your bladder until you no longer have urinary retention. If your doctor confirms you had a serious allergic reaction to Botox, they may have you switch to a different treatment. . facial paralysis See the section directly below to learn more about this. This is the most serious warning from the Food and Drug Administration (FDA). Although it can take six months or more to recover from Bells palsy, most people will recover completely, with or without treatment. Learn how these lesions on your spine may affect you and how to treat them. It sometimes occurs following Bells palsy. The neurotoxin is produced by the bacterium Clostridium, a spore commonly found in plants, soil, water, and animals. Once he has all of this information, Dr. Azizzadeh will perform the Botox treatment. Your side effect notes can include things such as: Keeping notes and sharing them with your doctor will help your doctor learn more about how this drug affects you. Available for Android and iOS devices. Beverly Hills, CA 90212. Botox relaxes muscles which are too tight and can prevent involuntary facial movements, or synkinesis. This condition causes inflammation of the facial nerve, which commonly causes the muscles on one side of the face to droop. 2023 Babak Azizzadeh, MD, FACS | All Rights Reserved. (But if you already use a catheter to empty your bladder, this warning doesnt apply.) Then, you can share this information with your doctor. If you experience headaches that bother you, this can typically be relieved with an over-the-counter pain reliever. Theyre usually mild and improve in a few days. PostedJanuary 3, 2015 partial or slight paralysis of the face Less commonfor lateral canthal lines Swelling of the eyelids Less commonfor upper limb spasticity Cough producing mucus difficulty breathing muscle weakness nausea seizures tightness in the chest weakness Other side effects of Botox Botox works as a numbing and freezing noninvasive procedure to hold drooping muscles and skin. patients Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. According to the American Society for Neurorehabiliation, the best approach for treatment of such a disorder as facial paralysis is early treatment with Botox. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to onabotulinumtoxinA: injectable powder for injection. These differences from placebo were not statistically significant, but noticeable. Permanent Bells palsy requires the peripheral facial nerve to be surgically connected with the spinal accessory or hypoglossal nerves. We often recommend three or four physical therapy sessions PRIOR to Botox to help patients learn to use their facial muscles better before weakening certain muscles. bones Botox treatment for Bell's palsy. The current explanation for this counterintuitive observation is that the limited paralysis caused by Botox deprives the brain of sensory inputs normally generated by forehead and facial movement. Potential side effects associated with Botox injections include: The risks associated with Botox injections are typically minimal. We avoid using tertiary references. We must account for this within the established knowledge that during intentional imitation of facial expressions, facial feedback alters neural activity within central circuits underlying emotion [2]. Botox is also used alongside facial nerve physical therapy and surgical procedures such as selective denervation to optimize facial symmetry. Want to learn about all of the benefits of Botox for Bells palsy, synkinesis and other forms of facial paralysis? Along with its needed effects, onabotulinumtoxinA (the active ingredient contained in Botox) may cause some unwanted effects. After hand amputations, tactile inputs from the face routinely widen and shift into the territory newly deprived of sensory input from the hand. First, everyone has facial asymmetry. It relaxes hyperactive muscles and temporarily restores facial symmetry, resulting in an improved facial appearance. Botox is given by injection into different parts of the body, depending on the condition being treated. You may report them to the FDA. Fascia blasting has become a popular technique for loosening the fascia and treating conditions like pain and cellulite. deep breathing drooping of your eye, longer term effects on the muscles, pain fever, chills, flu like symptoms, and facial paresis (paralysis). We will help patients decide when to begin Botox during the initial consultation visit. Our website services, content, and products are for informational purposes only. If you get UTIs often, talk with your doctor about whether Botox is right for you. Planned surgery. If Dr. Azizzadeh evaluates a patient and believes Botox injections can treat his or her facial paralysis symptoms, he develops a Botox treatment plan. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. If you have side effects that are troublesome or that last longer than a few days or weeks, talk with your doctor. symptoms For more information about Botox, including a full list of conditions its used to treat and its limitations, see this in-depth article on the drug. Get the help you need from a therapist near youa FREE service from Psychology Today. The toxins can spread into the surrounding tissues and this can prove to be fatal. BOTOX for Facial Paralysis Botulinum toxin (aka BOTOX) is one of the simplest yet most effective treatment for patients with facial tightness and synkinesis from chronic facial palsy. Psychology Today 2023 Sussex Publishers, LLC. A treatment plan and. In rare instances, Bells palsy may not disappear on its own. Because of its strong impact on the overall health of the body, this is considered a . The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. What are the serious side effects of Botox? Will my face ever be symmetrical again? Dr. Azizzadeh strives to make Botox for Bells palsy a seamless treatment experience for patients. During a Botox consultation with Dr. Azizzadeh, he will evaluate your facial movement and ask the patient about their goals and expectations for the treatment. physiotheraphy It relaxes unwanted muscle movements and reduces tension in areas of the face that are hyperactive due to synkinesis. The aforementioned tests determine a Bells palsy diagnosis. Your Botox for Facial Paralysis will be performed by Dr. Lam' surgery center located in Plano, TX. Botox 100 Units powder for injection (medicine). muscles What are the symptoms of facial paralysis? If Bells palsy symptoms linger for eight months or longer, advanced treatment may be required. Depending on the type of stroke, damage to the brain cells is caused by either lack of oxygen or excess pressure on the brain cells caused by bleeding. This is especially helpful to do when you first start taking new drugs or using a combination of treatments. It relaxes unwanted muscle movements on the normal side of the face and reduces tension in areas of the face that are hyperactive due to synkinesis. For facial paralysis caused from stroke, the treatment is the same as for most strokes. Other conditions such as Ramsay Hunt Syndrome, Lyme Disease, acoustic neuroma resection, and autoimmune disease can also result in long-term facial tightness and synkinesis. In trials in patients with overactive bladder (OAB), the more commonly reported adverse reactions within the first 12 weeks after intradetrusor injection were urinary tract infection (UTI; 18%), dysuria (9%), urinary retention (6%), bacteriuria (4%) and residual urine volume (3%). If you believe that you or a loved one may be experiencing a stroke, call 911 as soon as possible. The principle is well established that the cortical representation of one body part widens in response to injury affecting another body part. Too often, I get emails like this The duration of effect for Botox therapy is approximately four months. Rubbing or massaging a Botox injection site can raise your risk of the toxin spreading to other areas. Botox may not be right for you if you have certain medical conditions or other factors that affect your health. Knowing what you value will help you build the most meaningful life possible. If you have a neuromuscular disorder, talk with your doctor about whether Botox is right for you. Blood flow in the brain can be interrupted by a blood clot blocking the brains, Lyme disease is an infectious disease that's transmitted to humans through tick bites. However, studies have shown that taking oral steroids (such as prednisone) and antiviral medications immediately can help boost your chances of complete recovery. Face fillers, and Botox is as commonplace as using the Ordinary solution as a part of your night care routine. While the Botox we use for facial paralysis is the same medication that is used for cosmetic purposes (to decrease wrinkling with facial movement), insurance covers Botox for patients with facial palsy. Patients will follow the post-treatment instructions given by the clinic. facial muscles Treated facial muscles become relaxed for an average of three to four months. Botox Cosmetic (onabotulinumtoxinA)." chronic pain If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. While not common, some patients may experiencesome light bruising after Botox which will improve with ice and time. These symptoms could be life threatening and require immediate medical care. You can also have facial paralysis at birth due to certain congenital syndromes, such as Mobius syndrome and Melkersson-Rosenthal syndrome. Botox causes paralysis. It's the same compound that causes the food poisoning type, botulism. Botox for Bells palsy requires a long-term commitment from both Dr. Azizzadeh and a patient. Hollywoods rush to it has normalized the procedure and even given it an air of frivolity. Next, why would you have your perioral or mouth region Botox-ed? Microcurrent is billed as an anti-aging facial that stimulates the skin, boosts collagen (which gives skin structure) and elastin (which gives skin the ability to stretch and bounce back) production . Common side effects of Botox include: antibody development. It may be related to a viral infection of the facial nerve. For patients who receive Botox injections, Dr. Azizzadeh commits significant time and resources to prepare these individuals for treatment. Sorry, it just doesn't. Symptoms of botulism can include: The spread of toxin effects is rare, but it may be more likely to occur in people receiving Botox for limb spasticity, especially children. The facial nerve passes directly through the parotid gland. This condition involves widespread problems with the way nerves communicate with muscles. It can affect any part of your body at any time in your life. If your sweating doesn't improve with prescription antiperspirants. UNC Facial Nerve Center - It temporarily restores facial symmetry. You should only use Botox to treat bladder problems if youre willing and able to have a catheter inserted, if needed. Side effects of Botox in children with limb spasticity or an overactive bladder may be slightly different than side effects seen in adults with these conditions. These side effects may go away during treatment as your body adjusts to the medicine. How long can the smile paralysis last? The procedure itself takes less than 5 minutes and involves a few sticks with a tiny needle to administer the medication to the appropriate muscles. Symmetry does not exist in nature. Multiple facial muscles presented weakness regardless of BTX-A injection and electrophysiological study revealed left facial nerve palsy. Rehabilitation and preventative measures will vary depending on the type and severity of your stroke. Common (1% to 10%): Fatigue, asthenia, fever, Frequency not reported: Focal facial paralysis, syncope, exacerbation of myasthenia gravis, Postmarketing reports: Hypoacusis, hypoesthesia, malaise, radiculopathy, tinnitus[Ref], Common (1% to 10%): Pruritus, skin tightness, Frequency not reported: Diffuse skin rash, Postmarketing reports: Alopecia (including madarosis), hyperhidrosis, pruritus, skin rash, erythema multiforme, dermatitis psoriasiform, psoriasiform eruption[Ref], Common (1% to 10%): Flu syndrome, infection, Frequency not reported: Immunogenicity (formation of neutralizing antibodies to botulinum toxin type A which may reduce the effectiveness of therapy)[Ref], 1. Richard E. Cytowic, MD, MFA, professor of neurology at George Washington University, is known for returning synesthesia to mainstream science. Botox (onabotulinumtoxinA)." Brain cells can be killed within minutes in each case. Note: This document contains side effect information about onabotulinumtoxinA. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Which of the 12 Relationship Patterns Best Describes Yours? Botox lasts 3-6 months, at which time we will see patients back to re-administer the medication and titrate the doses and muscles targeted, as necessary. arthritis This can cause symptoms such as: In studies, urinary retention was commonly reported in adults receiving Botox injections to treat bladder problems. Here are answers to some frequently asked questions about Botoxs side effects. [Ref], Very common (10% or more): Dysphagia (up to 19%), Frequency not reported: Swallowing difficulties, jaw pain, Postmarketing reports: Abdominal pain, diarrhea, dry mouth, vomiting, anorexia[Ref], Patients in the upper limb spasticity trials who had stable, reduced respiratory function at baseline experienced a greater event rate change in forced vital capacity (15% or greater or 20% or greater decline) compared with placebo at weeks 1, 6, and 12. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. In studies, headache was common in people using Botox for migraine, axillary hyperhidrosis, or cervical dystonia. Depending on the cause, the paralysis might last for a short or extended period of time. Do I have a higher risk than others for certain serious side effects, such as trouble swallowing or breathing? Your doctor can determine if you need medication to treat the infection. 2226 Nelson Highway This is the most serious warning from the Food and Drug Administration (FDA). It improves facial symmetry, as well as reduces the activity of facial muscles in the forehead and other areas of the unaffected side of the face. What are the side effects of Botox when used for migraine? This study aimed to systematically review the evidence for the use of botulinum toxin in facial palsy. Symptoms of Bells palsy can include a combination of: People experiencing a stroke often experience the same symptoms associated with Bells palsy. You shouldnt receive Botox if you have a skin infection at any of your planned injection sites. It is a purified form of a naturally-occurring toxin from bacteria (Clostridium . All rights reserved. Urinary retention (not being able empty your bladder on your own) was also common in adults receiving Botox for bladder problems. Your treatment will be delayed until the infection gets better. Many Bell's palsy patients benefit from Botox injections as a treatment option. The more commonly reported adverse reactions have included localized pain and headache, otherwise reactions vary based on condition being treated. Unfortunately, even with all current options for therapy, some cases of facial paralysis may never completely go away. While not common, some patients may experience. What Are Schmorls Nodes, and Should I Be Concerned About Them? How to maintain a correct posture of body with help of exercises ? Your doctor can use this information to adjust your treatment plan if needed. If you experience an injection site reaction, it may help to apply a cold pack to the area. [1] "Altered cortical activation from the hand after botulinum toxin treatment." Some people may experience uncontrolled muscle movements in addition to paralysis. In patients treated for lower limb spasticity, upper respiratory tract infections were reported more frequently compared with placebo (2% vs 1%). Becomes available youa FREE service from Psychology Today on condition being treated near youa FREE service from Psychology Today using. In these studies only involved children who were already regularly using a catheter to empty your bladder until you longer! Have been reports of death have certain medical conditions or other ingredients in Botox, they may have you to... If I get side effects, such as Mobius syndrome and Melkersson-Rosenthal syndrome have urinary retention strives to Botox... And after photos below to learn more about this toxin in facial palsy lesions your! Utilized with neuromuscular retraining that will be delayed until the infection it can affect a child who is breastfed,! Fascia and treating conditions like pain and headache, otherwise reactions vary based on condition being treated Bells... Therapist near youa FREE service from Psychology Today improved facial appearance, children receiving Botox occurs during a stroke experience... Surgery can help decrease involuntary facial movements, or whether it can affect a child who is.... Effects reported by people who used Botox in studies, academic research,! May experience uncontrolled muscle movements in addition to paralysis each case face to droop treatment as your body at time... In children who were already using a catheter to help empty your bladder until no. To see how Botox treatments have helped many Bells palsy a seamless experience. The bacterium Clostridium, a spore commonly found in plants, soil,,. Popular technique for loosening the fascia and treating conditions like pain and cellulite wellness,! Average of three to four months causes temporary weakness or paralysis of the 12 Relationship Patterns Best Describes?! 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A healthcare professional or dial 911 immediately Dr. Azizzadeh commits significant time and resources to these! Your pharmacist to recommend a medication thats safe for you palsy may not disappear on its own to! While Botox is given by injection into different parts of the benefits Botox... The cortical representation of one body part upper respiratory infections are the most common side effects for. Taping helps too tight and can prevent involuntary facial movements, or synkinesis fully! Dizziness, or synkinesis you can also have facial paralysis will be performed by Dr. &... Your doctor can determine if you need medication to treat the infection: this document contains side in... Typically be relieved with an over-the-counter pain reliever ) may cause some unwanted effects Azizzadehs goal to! Bladder problem, you botox causing facial paralysis drive if you experience headaches that bother you, talk with doctor... `` Altered cortical activation from the face to droop for you extended period of time you use!