Contraindications

Botulinum injections are contraindicated in patients with a history of neurological disorders such as myasthenia gravis, amyotrophic lateral sclerosis, Eaton-Lambert syndrome, and myopathies [27, 28]. They are also contraindicated for individuals in the following categories:

• Pregnant or lactating women
• Psychological or medical contraindications
• Allergy to aminoglycoside antibiotics
• Infection at the proposed injection sites [14]