Can Botox cause facial nerve paralysis?

Author: Afton Schamberger  |  Last update: Friday, August 8, 2025

Some previously reported cases had too long interval from the final injection of BTX-A to the onset of neuropathy [3,8,9]. Based on three studies with valid methodology, the annual incidence of facial nerve palsy was estimated in the range of 25 to 100 per 100,000 [10-12].

Can Botox cause facial nerve palsy?

The risk of nerve damage from Botox is extremely rare. Botox is injected directly into the muscles and does not typically come into contact with the nerves. However, in rare cases, the needle used to inject the Botox can cause nerve damage.

Can nerve damage from Botox be permanent?

Another potential risk associated with Botox is nerve damage. In rare cases, the injections can damage the nerves near the injection site, leading to muscle weakness, numbness, and tingling. These symptoms usually go away with time, but in some cases, they may be permanent.

What triggers facial paralysis?

It may be caused by damage to the facial nerve due to injury, infection, or a brain condition such as a stroke. Patients may have difficulties with blinking, swallowing, eating, and showing emotions through facial expressions.

How long does Botox paralysis last?

Botox blocks nerve signals to muscles. As a result, injected muscles can't contract (tense up). These effects are always temporary, but can last for several months.

How Botox Injections Can Aid In Facial Palsy Recovery

Can Botox cause neurological issues?

FDA has reported adverse events after BoNT injection affecting nervous system far from initial site of injection such as speech disorder, nystagmus, restless leg syndrome, and even coma. Central nervous system involvement included 23.5% of serious and 24.9% of non-serious events (1).

What is the biggest risk of Botox?

Serious adverse effects after cosmetic use of botulinum toxin include dysphagia, muscle weakness, and allergic reactions [22, 23].

How do you reverse facial paralysis?

Facial reanimation procedures include:
  1. Corneal Neurotization.
  2. Nerve repair or graft.
  3. Nerve transfer.
  4. Muscle graft (gracilis)
  5. Temporalis tendon transfer.
  6. Injections.
  7. Physical therapy.
  8. Selective neurectomy.

How do you know if facial nerve damage is permanent?

If the paralyzed muscles display less than 10 percent of the function that healthy muscles show on the other side, this may suggest that the paralysis may be permanent.

What deficiency causes facial paralysis?

Although rare, hypovitaminosis A as a cause of facial nerve paralysis is important, as in our case, it was the infant's only presenting symptom.

How to know if Botox hit a nerve?

Signs of nerve damage after fillers

Delivering stringent aftercare is also key, so your patient knows what signs to look out for and who to contact. Dr Lindsay informs, “Often a patient with a nerve injury will initially report a sharp electric shooting, burning, itching, tingling or a pins and needles sensation.

What happens after 20 years of Botox?

Muscle Atrophy and Adaptation: After long-term Botox use, some facial muscles may experience mild atrophy due to limited activity. This can actually benefit patients who prefer a smoother look, as muscle activity that causes wrinkles is minimized.

What is the best alternative to Botox?

Below are 10 alternatives to BOTOX® that might help if you're seeking smoother or firmer skin on your face.
  • Cosmetic Acupuncture. ...
  • Microneedling. ...
  • Chemical Peels. ...
  • Laser Therapy. ...
  • Cryotherapy. ...
  • Facial Creams. ...
  • Neuropeptides. ...
  • Face Patches.

What infection causes facial nerve palsy?

Facial nerve palsy can be associated with infections, most commonly HSV, as well as VZV and HIV, Lyme disease, and Mycobacterium tuberculosis. Noninfectious causes include sarcoidosis and neoplasms.

Does Botox damage facial muscles?

Aesthetic botulinum toxin injections may result in atrophy of the injected facial muscles. The long-term effects and diffusion of botulinum toxin in the facial muscles are pitfalls in the neurophysiological diagnosis.

Can Botox cause trigeminal neuralgia?

A rare case of trigeminal neuralgia following injections of Hyaluronic Acid and Botox was documented. In addressing the severe pain and swelling caused by the injection, a novel combination therapy was employed, notably including 5-fluorouracil.

How to stimulate facial nerve regeneration?

Facial Stimulation
  1. Step 1: Begin by trying to move every part of your face slowly and gently.
  2. Step 2: Use your fingers to gently lift your eyebrows. ...
  3. Step 3: Using your fingers, gently massage the different parts of your face, including your forehead, nose, cheeks, and mouth.

What is the most common cause of facial paralysis?

Bell's palsy is the most common cause of facial paralysis. Symptoms of Bell's palsy include: Sudden weakness or paralysis on one side of the face. A drooping eyebrow and mouth.

Can MRI detect facial nerve damage?

Magnetic resonance imaging (MRI) is useful for identifying soft tissue abnormalities around the facial nerve, as seen in inflammatory disorders, neoplasms, and hemifacial spasm. Facial nerve ultrasound has been used in a recent study to predict functional outcomes in Bell's palsy [1].

What vitamin helps with facial paralysis?

MeCbl is an active vitamin B12 that has been reported to promote nerve regeneration and is effective for facial paralysis [16].

What autoimmune disease causes facial paralysis?

Guillain-Barre Syndrome can cause facial paralysis, as well as weakness and tingling in other parts of the body. Multiple Sclerosis: Multiple sclerosis is a chronic autoimmune condition that affects the central nervous system. It can cause a wide range of symptoms, including facial nerve damage, numbness and tingling.

What can be mistaken for Bell's palsy?

The common symptoms of Bell's Palsy and Ramsay Hunt Syndrome are similar in that they both involve facial paralysis. However, there are some differences between the two conditions. Bell's Palsy is caused by damage to the seventh cranial nerve, while Ramsay Hunt Syndrome is caused by the varicella-zoster virus.

What happens after 10 years of Botox?

If you use Botox for ten or more years, your skin will appear brighter and smoother with fewer wrinkles. Even after stopping Botox injections after years of use, you'll still notice fewer wrinkles between your eyes or on your forehead, which means you'll continue to age gracefully.

What is the downside of facial Botox?

The procedure can result in unwanted results or even cause harm if it's given incorrectly. Possible side effects and unwanted results include: Pain, swelling or bruising at the injection site. Headache or flu-like symptoms.

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