title: Low-dose subcutaneous injection of botulinum toxin type A for facial synkinesis and hyperlacrimation.
abstract: OBJECTIVE
  To investigate the efficacy of low dose of botulinum toxin type A (BTX-A) for facial synkinesis and hyperlacrimation.
  
  
  METHODS
  Eleven patients suffering from facial synkinesis after Bell's palsy or facial nerve injury were treated with a low dose of BTX-A, 0.5-1.25 U per point into several points. One patient showing hyperlacrimation was also treated with BTX-A. The whole observational period was 43 months.
  
  
  RESULTS
  On average, 5.76 U of BTX-A, which was lower than that of previous reports, was injected per treatment. In seven cases, synkinesis disappeared completely after three or fewer sessions of BTX-A injection. The mean interval between treatments was 14.5 weeks. Hyperlacrimation was completely suppressed after a single subcutaneous injection of BTX-A. Only mild subcutaneous hemorrhage was observed as adverse reactions.
  
  
  CONCLUSIONS
  Facial synkinesis can be treated with a lower dose of BTX-A without relevant adverse reactions.
authors: Department of Neurology, Tokyo-West Tokushukai Hospital, Akishima, Tokyo, Japan. hishashi.ito@tokushukai.jp
authors: H
authors: H
authors: Ito
authors: H
authors: H
authors: Ito
authors: S
authors: S
authors: Nakano
authors: H
authors: H
authors: Kusaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007766:Lacrimal Apparatus Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D046608:Synkinesis / Q000188:drug therapy*; D013666:Tears / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A