Modulating Neuromuscular Junction Density Changes in Botulinum Toxin–Treated Orbicularis Oculi Muscle

While botulinum toxin injections are effective in reducing muscle spasms in blepharospasm and hemifacial spasm patients, they have a relatively short duration of action due to formation of new functional neuromuscular junctions. Co-injection of botulinum toxin–treated eyelids with corticotrophin-releasing factor or antibody to insulin growth factor–receptor prevented neuromuscular junction increases. The long-term goal is to increase the duration of effectiveness of botulinum toxin and reduce the lifetime exposure in patients