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Junghans K, Rohrbach S et al. Head Face Med 2007; 3: 32

Apart from its use in facial cosmetics, botulinum toxin has therapeutic applications such as the treatment of chronic facial pain and facial dystonia. This case report describes the immediate relief of pain after serial injections of botulinum toxin type A (BTX-A), for a patient who experienced intense symptoms, of some 10 years duration, following surgical management for severe osteomyelitis. Pain had only partly been relieved by carbamazepine and extra-oral pressure points and there had been suicidal thoughts. The patient also experienced dyskinaesia of the caudal mimic musculature with accompanying eczema that too healed after treatment with BTX-A. It is stated that this modality should be reserved where conventional treatment has not succeeded, the symptoms are severe and it should be performed by multidisciplinary teams.