Botox's surprising other uses beyond wrinkles: Migraines, crossed eyes and other conditions

Botox injections are used for a variety of medical and aesthetic reasons. If you or a family member are considering them, here are five things you should know about the procedure.

1. What it is and how it works
Botox is the brand name for injectable botulinum toxin type A, a protein created by the bacterium Clostridium botulinum. This bacterium can be found in some spoiled food and releases a potent neurotoxin that can be fatal if consumed. However, injecting the synthesized protein into muscles weakens them only temporarily.

2. Common uses
The muscle-weakening action of Botox can smooth facial wrinkles and treat movement disorders of the eye and head, spasticity, migraines and excessive underarm sweating.

3. Crossed eyes, migraines, cerebral palsy and other medical uses
Injecting Botox directly into muscles that control the eyelids reduces spasms in patients who suffer from blepharospasm, or rapid, uncontrollable blinking. When the condition is severe, patients can become functionally blind because their eyes never stay open long enough for them to see. In one small study of 14 such patients, 73 per cent of the treated eyelids returned to normal after Botox injections.

Bulging eyes caused by overcontraction of eyelid muscles as a result of Graves' disease respond well to Botox injections. Strabismus -- crossed eyes or otherwise misaligned eyes -- has been successfully normalized with Botox injections as well. Botox is also used to control involuntary head- and neck-muscle contractions (focal dystonias) by reducing not only movement but also neck pain caused by constant head twisting.

The same injections also help reduce spasticity and improve gait, range of motion and appearance in children with cerebral palsy and adults with spasticity problems. Some doctors, including Dr. Alastair Carruthers, a clinical professor at the University of British Columbia (UBC) in Vancouver, have found that Botox injections help prevent migraines in patients with frequent migraines. Because Botox can disconnect nerves from sweat glands, says Carruthers, it is also approved for the treatment of excessive sweating, which is thought to be triggered by overactive nerves.

Botox is also successful in its cosmetic uses; namely, reducing facial lines and wrinkles. As skin loses its elasticity with age, "people smile, and wrinkles remain where they are, whereas the skin bounces back when people are young," explains Carruthers. By relaxing the muscles that cause lines to form, botulinum toxin corrects the underlying cause of wrinkles and furrows.

The injections themselves are usually not painful: they are often likened to the sensation of a pinprick. No anesthesia is required prior to receiving an injection, though physicians may numb the skin first with a cold pack or anesthetic cream.

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