Botox injections not just for cosmetic enhancements

“The treatment gave me my life back,” she said. “I hadn’t felt that great in a long time.”

Dr. Tom Steeves examines patient Carolea Fox at St. Michael’s Movement Disorders Clinic. (Photo by Evelyne Jhung)

Dr. Tom Steeves examines patient Carolea Fox at St. Michael’s Movement Disorders Clinic.The injections weren’t for cosmetic reasons, however. About 12 years ago, Fox began experiencing uncontrollable blinking and severely dry eyes. The hearing loss and pain in her neck came a bit later. She was put on a cocktail of pills for her ailments and even underwent surgery for her dry eyes, but nothing seemed to work. When her husband died a couple of years ago, “my neck went crazy,” she said. “My neck kept jerking to the side and it hurt to put my head down on a pillow. I thought it was from the stress.”

Fox was finally diagnosed with cervical dystonia two years ago and referred to Dr. Thomas Steeves at St. Michael’s Movement Disorders Clinic. The clinic treats a full spectrum of movement disorders, including atypical Parkinsonism, Parkinson’s disease, chorea and dystonia – a group of movement disorders caused by sustained muscle contractions that produce repetitive movements and abnormal postures, like Fox’s constant blinking and neck-turning.

“Dystonia of the head and neck, called cervical dystonia, and task-specific dystonias, such as writer’s cramp, can be very painful and have a huge impact on a person’s ability to do everyday things, like drive or work,” said Dr. Steeves, head of the clinic and a staff neurologist. “It can really affect the quality of a person’s life.”

A common treatment for such movement disorders is botulinum toxin injections – often inaccurately referred to by its brand name, Botox. There are a handful of clinics in Toronto where patients can get these injections, which have been successful in relieving spasms, unwanted movements, abnormal postures and pain as a result of movement disorders.

St. Michael’s is one of three hospitals in Toronto that offer EMG, or electromyography-guided injections of botulinum toxin. The EMG measures electrical activity in the muscles and is used to target the toxin to the muscles that are the most overactive. It is needed for complex dystonia cases, such as writers’ cramp or musicians’ dystonia, and is also helpful for cervical dystonia and in particular, for the treatment of dystonic head tremor. “It’s a slowly acquired skill,” said Dr. Steeves.

Fox is grateful to Dr. Steeves and the clinic, saying, “The effects of the injection were immediate. Within the day, I felt like my world had changed. I could put my head down on the pillow and sleep, and my blinking stopped. I finally felt healthy and great again, like the person I used to be.”

About St. Michael’s Hospital

St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.