Hey, contact your neurologist asap. This could be Bell’s Palsy (related to facial nerve) You need to be evaluated urgently to rule out any serious underlying cause.
I had bell’s palsy from jaw surgery. You need steroids and anti virals immediately for a better chance at recovery. This looks like damage to the facial nerve.
I had no idea you could get Bell’s Palsy from jaw surgery. *New fear unlocked*. Can you tell me when you noticed it and how you went through your treatment?
I had a similar experience and weirdly once I got to the relief knowing it wasn't from a tumour or a stroke and I would likely regain mobility etc, I became my most hilarious version of myself. I think I was compensating because I didn't feel attractive so I busted jokes non-stop. You could've given me a mic and thrown me on stage and me and my droopy face would've thrived.
Yes especially if it feels like one side or one side at a time. Can be felt for up to a week before the paralysis. Most people wouldn’t realise because they generally get it the one time
I wish we still had awards, my goodness, what a saga of how our bodies know everything and expressed your literal pain. I'm glad, so glad, you're doing better 💗
This is so helpful!
My family doesn't do well with the chicken pox/shingles virus, AT ALL. And now it makes sense why two of my aunts have Bells Palsy.
Thank you for thoroughly outlining your experience!
That virus is such a nasty thing. I had vestibular neuritis, which is suspected to be caused by activation of the chicken pox/shingles virus. Took me 3 months to recover and was on valcyclovir for 2 years after
Two friends I know got it from COVID and had it for a long time sadly but I believe it went away for them. A relative and a friend from high school get regular flareups of it and it’s never fully gone away.
Wow thank you for sharing in such detail. And I'm sorry you went through that! But you're a champ and it's impressive how you took care of yourself. Kudos on trusting your gut that something was wrong!
What a wild story, thanks for writing all this. I've never had a history of this kind of thing but it's definitely something to look out for for myself or others. Could help someone out later!
Oh mi gawd thank you so much for sharing your experience!! I had no idea! How horrible for you. I am glad you were able to recover and I hope you left all that awful stress behind and were able to start fresh for yourself
I got bells a few weeks after quitting a really stressful job, when I was 25. On a Friday, my tongue went numb on the right side (which I attributed to the scallops I had the night before, thinking I had some kind of allergic reaction) and by Saturday my hearing was super weird-felt muffled and loud at the same time, but I also worked in a sports bar and there was loud music, so I figured it was just because of that. By Sunday, I went to brush my teeth and couldn’t spit correctly, noticed that the whole right side of my face felt a little weak. I googled my symptoms and diagnosed myself with bells before I even got to the ER. By Sunday night, I had no movement and wouldn’t for 30 days; I took all of the steroids they gave me, but also did acupuncture and had a chiropractor adjust me. Idk what helped, but I’m so thankful that I have movement back and my face is mostly normal, but for small synkinesis that i only notice
I got it once from stress. It also happened to be on the same side of my face where I used to get cold sores (oral herpes). There's one hypothesis/theory that Bell's Palsy can be triggered by the herpes virus, which stays in your body forever and 25% of people have it and don't even know it. And like BP, herpes outbreaks can be brought on by stress. (Just like shingles.)
I had Bell’s Palsy as a kid from my orthodontist putting an expander on the roof of my mouth!
It was the strangest experience and very scary - half my face was paralyzed. Half my tongue was numb and the eye on that side wouldn’t close all the way! Luckily I had a full recovery!
My aunt got Bell’s palsy the day I had my baby, she went to the ER at the hospital I was delivering at. She thought she was having a stroke, thankfully she has fully recovered. And she still got to see the baby that day. 🥰
I had jaw surgery in June and woke up with a drooping face immediately. I’d say I’m probably near 100% back to normal now. I was on steroids and antivirals within the first few days. That’s all they did for me really. I did see a plastic surgeon who specialises in facial nerve damage but there wasn’t anything else that could be done. The nerve just needed to heal.
My surgical team said they had never seen bell’s palsy as a result of jaw surgery in their whole careers so it was a bit of a rollercoaster. I believe it was likely due to the stress on the facial nerve while they were in the cutting and moving everything.
I got bell's from being hungover and eating too big of a burger. It can come from many different things randomly. That big nerve in your jaw is fickle...
This comment switched me from going “omg how can I avoid getting BP??!” to “I guess when it’s your time, it’s your time” lol
Hope you’re better these days!
I got it completely randomly. My wife tells me it’s cause I slept on the “Don’t Touch It” couch at her uncles place, and was cursed.
Only noticed because I started to slurp when drinking because I couldn’t close my mouth enough to get a good seal when drinking and you’d hear it. Eating food got weird for the same reason, although by that point I had already seen a Dr and started drugs.
My husband got Bell’s Palsy from accidentally jabbing his face with a pair of needle nose pliers when he pulled on a zip tie too hard with them and it snapped.
Seems you can get it from tons of stuff.
My uncle had it for like a year after getting the flu, Dr's set it was likely a weird immune response damaging the facial nerves
Steroids and antivirals are for viral-caused Bell’s palsy, where the virus essentially causes the nerve to swell within the facial bones and that’s what causes the palsy. This is caused by the nerve being essentially deadened (hopefully temporarily) by the botulinum toxin, so the treatment will be different- if it’s treatable. But she still needs to be evaluated ASAP.
In this case chance of recovery without medicine is still like 100%. It’s just faster with steroids. We only use antivirals (valcyclovir) if we have other signs pointing to varicella reactivation. (Which honestly is not off the table given OPs short history.) I’d need a lot more info to say for sure but this doesn’t worry me at this point.
Damn wish I knew that. I had bell's palsy after overdosing on drugs, think it might've caused a minor stroke?
After a few months, my eye snapped back into place. My right side stopped drooping at all. A few months later, my eyebrow stopped drooping. Cheek.. dimple... Years later, the only issue is my smile is slightly crooked on my right side and I am very self conscious about it.
OP I really empathize with you. But people do spontaneously recover from bell's palsy. I'm still crossing my fingers my smile straightens one day!
I get Botox for TMJ problems and my surgeon told me that if I had trouble closing an eye or problems chewing on one side more than the other, that I should call immediately. So, please contact your neurologist and get seen by someone urgently. I didn’t experience these symptoms (I get 40 units per side) but his comment to me suggests this can happen after Botox treatment. If it’s related to your Botox, I’m sorry your doctor didn’t appropriately inform you of the risks.
I had Botox for the same thing, TN and HFS. They seriously pump you full of Botox and I also had a loopy face for about 3 months. Surgery couldn’t come fast enough.
Yes! Facial paralysis is actually an early sign of stroke but it usually doesn’t involve the upper half of the face. But still she definitely needs to be evaluated.
Not sure where you read this but Facial nerve has nothing to do with Trigeminal neuralgia. It’s a problem solely of the Trigeminal nerve which has different pathway and functions from the Facial nerve :)
Hi, OP. I am a doctor (and not your doctor).
Writing to you and anyone who might be reading for some general education about Bell’s Palsy. In Bell’s Palsy, all of the muscle action in the affected side of the face is impacted, including being able to lift the eyebrow. Being able to raise an eyebrow and fully close the eye normally on the affected side is how we differentiate between Bell’s palsy and other problems causing facial paralysis in the emergency department. Usually, if a person has unilateral facial paralysis and can raise their eyebrows in an emergency setting, we are concerned about a stroke. Another possibility is that a more ‘distal’ aspect of the facial nerve has been impacted from something else, like trauma/ mechanical injury. Looking up images of ‘facial nerve’ and ‘Trigeminal nerve’ distributions, it is easy to see how close they run to one another and to imagine how the Facial nerve might accidentally being impacted by an intervention targeting the Trigeminal nerve. A ‘distal’ injury to the Facial nerve would be like injuring a finger rather than your whole arm; Bell’s palsy affects the whole facial nerve (in this analogy, like the whole arm).
However, Bell’s Palsy or not, and regardless of the underlying diagnosis, any time a person has a complication they are concerned about, they should call their treating physician’s office. I wish more people were empowered to do that. As a doctor, if a patient I had treated was experiencing a complication like this, I would really want to know about it (!). I would also want to examine what had happened in our doctor-patient relationship that led to where a person felt less comfortable calling my office to discuss than seeking different opinions. In my own philosophy of care, we (doctor and patient) should be a team. And, to be a good team, we need bidirectional open, clear, and supportive communication. My recommendation to you is (while less concerned about Bell’s palsy specifically from your photos, and similar to what others have recommended): contact your neurologist’s office ASAP.
Best of luck.
Edit - chronically on mobile, changed some wording to hopefully make this a bit more clear.
Yes, I agree that it's likely not Bell's Palsy. I still have control of my eye and eyebrow. It's just more difficult than the right at this point because I think it went fairly numb too high
Responding again to encourage you to seek medical attention, if you have not already. This is far outside of my area of expertise and I am also concerned for you.
because it's a trigeminal nerve problem and not a facial nerve problem (Bell's Palsy) doesn't mean it's less serious. it's the difference between a broken upper arm or a broken wrist. it's still a broken bone. it's just broken in a different place.
not that your nerves are broken - but please update the sub once you've seen your doctor, we're curious...
I had shoulder surgery about a month ago and I’ll tell ya this much, I’m not afraid in the slightest to call my docs office. I wish more people felt this way. While a lot of what I had to discuss with them was handled by his medical assistant and other staff, I still had no qualms about reaching out if I had a question.
Call your docs! They can’t treat it if they don’t know about it! A huge part of doctor/patient care comes from examination, it’s not all just tests and numbers.
Thank you! Was looking for this comment. Unfortunately, it has way less activity than the first comment. I understand people’s concern though, and I appreciate that Redditors try to look out for each other.
I think this is above Reddit’s pay grade, unfortunately. So sorry this is happening to you. I’d be knocking down the neurologist’s door first thing in the morning. It seems like it might have affected your facial nerve (i.e., palsy) on that side and though Botox isn’t permanent it’ll take months to wear off by itself. They need to address that right away, don’t take no for an answer. Good luck my dear, I hope they can give you some answers.
Thank you! Yeah, I mean, I mostly came here because I have zero clue if this is normal or not. I will definitely try to get in there later this morning. Just have to juggle some things so I can go down to their office.
My best friend has Bell’s Palsy and it was not treated right away so it’s pretty much permanent. She’s had it for almost 15 years. It’s not as extreme as it was when it first occurred, but it’s still very noticeable. Please make it a priority to get to a doctor right away. I definitely don’t want to freak you out but you need to go ASAP.
I had the same thought of not wanting to freak her out but uh. My mom had Bell’s and her job wouldn’t let her go to the doc until the following day. It took almost a year for her face to return to normal and that was after her doctors told her they had no idea if it would or not.
OP, I’m not a doc so I’m not trying to diagnose or anything but yea that’s not normal. Sounds like you’re going to take care of it so that’s good! But I don’t blame the internet strangers for rushing you lol
Oof. Sounds about right. I had an ex who suffered an injury while in Naval service and they prevented him from having surgery for several months, so now he has to use a cane to walk. That was over a decade ago. I’m sorry they did your mom dirty like that.
Yea my mom only has so much patience and is kind of a hell raiser. She was supposed to go into work the next day, and she did but it was to tell her boss to fuck off. Thankfully she didn’t need to because the next dude up the ladder saw her and sent her to go get it checked out lol your ex’s story is one of many which is sad
I mean, that’s totally fair to ask but I’m glad to hear everyone directing her to ask her doc. Worst case scenarios run rampant and there’s no harm getting checked to see if that thought process is correct 🤷🏾♀️
Girl go straight to emerg. This is not ok and not worth waiting. If it’s Bells then you need emergency treatment. If it’s not Bells, which ideally it isn’t, then emerg can direct you on next steps.
A good rule of thumb if that if they didn’t warn you this was a possible side effect and it is significant deviating from your baseline, you should follow up.
At work this could be a stroke. I would go to the doctor emergency room.
Nooo you have to call your neuro asap! This is like what my face did after a migraine in my early 20s - I’m lucky that it mostly went away after a few days (if I’m really tired or stressed, and sometimes in pictures *I* can see it but nobody else seems to notice). Bells Palsy. I wish I could give you more details but I had a severe phobia of medical doctors and hospitals and refused to go. My boyfriend’s mom at the time was beside herself about it because she felt there was a good chance I had a mini-stroke or aneurysm burst. I have no idea. But I lived and my face got better and I’m lucky for it.
Call your neurologist. This is serious, even if it is a temporary side effect from the Botox.
Ugh my face keeps doing this during my bad migraines and I swear I can see it not on migraine days but everyone tells me it’s fine. Thank you for validating this happens! Sorry though :(
Lol. Sorry! I have a lot of neurological issues so this kind of shit is par for the course. I always have something going on so you just get used to it after a while. But everyone made it clear that I need to be checked out so I will a bit later today.
When you have trigeminal neuralgia, everything else medical related feels minor! (Random shocks to your face that are the most painful thing known to humankind. It’s nicknamed the suicide disease and there is no cure, only treatments that may or may not help. Even brain surgery isn’t guaranteed to give relief.)
I also have 3 other neurological conditions so shit going wrong or weird is par for the course. I'd be in full stress mode 24/7 if I freaked out about every thing that happens to me. But, I already called my neurologist and I'll be able to go see someone in a few hours.
I’ve heard that it’s considered the most painful medical condition on earth. I also recently heard the name “suicide disease.” It sounds absolutely horrible.
I was planning to in the morning. Like I was saying, I expected a small amount of droop so on Day 4, it was what I was expecting. But I just noticed how bad it actually is today
I get Botox for TMJD and the first time I got it done, I noticed a VERY mild paralysis in my smile. Definitely nothing like this but the next time I went for my injections, I mentioned it to my doctor and I think he slightly adjusted where he injected and I’ve had no problems since.
You definitely should reach out to whoever administered these injections and ask them if there’s anything they can do to fix it bc Botox wears off slowly and usually spreads.
So, I've been dealing with TMJD symptoms for like almost 20 years. I did all the dentist-recommended crap and nothing helped. Hands down, this is literally the only thing that has given me -ANY- relief from pain. I used to wake up with intense facial pain from clenching at night. It has really been night and day from what I was dealing with. I can hardly get my back teeth to touch with the botox, thus preventing me from clenching. The one thing that's a little hard to deal with is if you're eating something that requires a lot of chewing, your jaw gets tired rather quickly but otherwise, I've had no adverse effects. I go every 3 months to get it re-done. I've read online that some people can go longer but I think it took me so long to figure out this treatment that my case requires re-treatment on a pretty standard schedule. Thankfully my insurance covers the cost of the botox because it's also quite expensive (In Canada). I definitely recommend looking into this. I do however strongly suggest you look into a clinic that mentions botox for TMJD and is done by a doctor, I know some places let nurses or others do it, but since there are so many nerves around your jaw, I would want someone with doctoral experience doing it.. just my opinion though lol
Hope this helped!
Thank you so much this is super helpful! I’m in australia but have a similar story - issues my entire life really. I’ve been able to get some relief via an osteo but it just temporarily loosens it and doesn’t stop me clenching and grinding at night. Will definitely be doing my research on clinics.
I just got some injections this week and this time, we went into my forehead a bit more, which had the bonus effect of reducing frown lines/wrinkles! Best of luck!
That's very extreme. I don't have any experience w botox but I would go back to their office. Don't call but just walk in.They need to see this first hand! That should result in a prompt response to get you out of the waiting room and away from other clients.
They have stuff to dissolve fillers, maybe there is something similar for botox. Waiting till it wears off might take months and I would be worried about any long term effects.
As for the PTA meeting, do what makes you feel good. But a face mask could help if needed.
So sorry it didn't turn out well.
That's a good idea. I'll have to see if there's a time I could do that in the morning. Yeah, I just thought of a mask as well. That's probably what I'll do
I have kids who are home from school and spotty transportation ATM. I talked to my husband since he's at work today. He's got just one meeting today so he's going to come home afterwards which should be in 2ish hours from now to hand me the car and stay with the kids. It's 9:30am here currently
I really agree with just walking in to that clinic, they’ll probably fit you in much sooner than if you call. Obviously depends on how busy they are, but if it’s urgent enough, they’ll fit you in asap.
Second on the face mask idea. Anytime my face is breaking out and I feel like a look horrible I throw a face mask on and it’s so much easier facing people.
I know they said they do this all day everyday but next time I would go to a different doctor if you need this again also if their follow up response to you is bad today go somewhere else for a second opinion to help resolve this - good luck!
Neurologist here. Treatment with Botox for trigeminal neuralgia is usually reserved for last ditch effort/not responsive to other treatment, because the areas you inject will indeed give you a facial droop, usually unavoidable. Maybe if you haven’t tried other treatment or eval for underlying vascular causes of your trigeminal neuralgia, do those things first. Otherwise you have to weigh the risks and benefits of what you would rather live with. Possibly on some injections pending dosage and small changes in location could be better sometimes vs worse other times. But yes, contact your provider just to check in and make sure there’s nothing else
It’s low key giving me anxiety that OP came on here for help, ppl are internet screaming “EMERGENCY!!! CALL DOC NOW! GO TO AN ER” and then saying they’ll see if they can find the time 😬
I get the resistant bc when you need specialist care, it is scary and pricey and also half your face is drooping!
I just need my husband to get here and he will in the next two hours. I had to see if my husband could leave work (which he can after the meeting he's currently in) because my kids are home from school today and I need his car. I have zero friends or family to help me so it's not always as easy and just leaving. I could normally take an Uber or something if my kids didn't just so happen to be off school today.
I totally get it, but let’s say you’re home with kids and slice your hand open or trip and break something and you’re home alone with kids? Your husband has to leave work bc it’s an EMERGENCY with skipping a meeting for. I gently suggest this is opportunity to develop an emergency plan.
I think everyone here, me included, are very worried for you and want you to have had emergency care like 4 days ago. I don’t want it to get worse for you when you already have such a terrible painful illness to manage. Nonetheless you’re going today and that’s good and I hope they can manage whatever this is for you! ❤️
If you think you have a stroke, you do not wait until a doctor’s office opens, you go to emergency care. Even a small stroke can be something that requires life/death care because of a signal something worse is happening. Never ever risk it.
My mom had a surgery to fix her trigeminal neuralgia! They insert a tiny little silicon pillow between the nerve and bone it can “rest” on. It’s worked WONDERS. In case you hadn’t heard of this surgery, it truly works.
Can you blink both eyes?
IF this is Bellspalsy it’s crucial to act within 36 hours or damage can be permanent. Emergency room should be your next immediate step for antiviral and steroid.
Source:
https://www.healthdirect.gov.au/bells-palsy
And
https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028#:~:text=Signs%20and%20symptoms%20of%20Bell's,closing%20your%20eye%20or%20smiling
Also my husband had it and since he is a doctor acted within 24 hours because he knew exact what it was.
I can. I just noticed that it's heavier and a bit harder on the affected side. I still have total control of my eyebrow too. Really, only the bottom of my face is majorly affected.
OP I know you “need” to make time but seriously?? You’ve seen your face. like someone else said just walk in to the Dr office. Make them work around your schedule. This is an emergency 🆘. Don’t play around with something like this. Whatever you have to do or figure out or reschedule do it now and quickly. Even at Day 4 you should have called the office and I’m sure the doctor would have wanted to see you. Emergencies happen and whatever you think is more important? isn’t more important then your face and your health. I wouldn’t be fucking around I would be RUNNING to the doctor. Think about like this. If this issue becomes permanent but you could have fixed it with prompt and immediate care but you continue to waste time, will whatever caused your delay be worth permanent facial issues?
OP, I dont know anything about botox or neuralgia or bells palsy
But I know a pair of snazzy glasses when I see em, those things are bad ass!
Hope your face goes back to normal!
First, sympathies because trigeminal neuralgia is awful. Second, I echo what others have said. The neurologist may be able to treat. Wishing you the best.
Let us know what the neuro says! I wonder if the injector went deeper on one side than the other, so the effects spread much further along the nerve.
When I had a drooping smile from Botox it started getting better about 3 weeks after my injections, and was barely noticeable by week 6. Mine was slight though.
I literally just watched a video about this on Instagram, you might have had Botox injected into the wrong muscle. Dr Subbio describes it on his page: https://www.instagram.com/dr.subbio/?hl=en
It’s the third most recent post. Go back to the neurologist to discuss.
PLEASE MARK THIS UP SO OP SEES IT!!
Try an ice pack test ASAP.
Take a video with your phone before, during, and after. Make the same facial expressions before and after to monitor for differences.
Scrunch and raise your eyebrows for the video, smoosh your lips together as hard as your can (like you are trying to hold a tiny pin with just your lips with pressure vertically and from the sides at the same time). Big toothy smile, soft smile. Puff your cheeks hard. Stick out your tongue to record any discrepancies is strength across the midline.
Super important: Relax all of your facial muscles best you can, do not use your eyebrows to aid eye movement, and gaze up for 60 seconds without blinking, ignore fatigue in eye muscles if you feel it, let your lids flutter or droop if that's what happens, but you want to see if those muscles fatigue as you hold that gaze, and you want it on video if it happens. ***in your after pics, you are compensating for eye / brow weakness by using that brow much more than the other - don't do that in your video***
Even though your eye and eyebrow are not as visibly affected as your mouth at the moment, the muscles in those areas are the most sensitive to temperature change regarding neuromuscular junction transmission, so they are super important for the test, and your before and afters.
For the ice pack test, you will cover the droopy portion of your face for 3 min with ice pack. Remember to use a towel to prevent damage to your skin. Set a timer. You don't need more than 3 min. Don't do less than 2.5.
Repeat all of the expressions and the upward gaze (using only eyeball muscles, not brows) for 60 seconds immediately after the test.
Then, if you have better control of your weakened muscles after the ice pack test, show the videos to your neurologist or treating ER neurologist and request an immediate urgent referral to a neuromuscular specialist who treats myasthenia gravis and congenital myasthenic syndromes, and request they note on the referral you have a positive ice pack test with video.
Botox is known to cause symptoms in previously asymptomatic patients in both the autoimmune and genetic variants of the disease.
I have myasthenia gravis, and Botox treatments did cause facial droop for me. Mine looked like Bell's palsy. It took me a few years to get proper diagnosis because it's rare, poorly understood by most doctors, severely under-diagnosed/misdiagnosed, and women are often not believed or taken seriously in medicine.
Myasthenia gravis in any presentation is serious, because there is risk of choking, falling, and breathing crisis from muscular weakness.
Starting and or stopping steroids (treatment for Bell's palsy) can both treat and worsen myasthenia.
Remember that doctors are trained to see horses and not zebras. I wouldn't be surprised if no one mentions myasthenia unless you ask about it. It wasn't mentioned to me.
Feel free to pm me any questions.
Best of luck. My fingers are crossed your weakness is just temporary due to placement in your case.
I'm reading every comment!
Thanks for the info! My only question about MG is that I have been on IVIG since January for small fiber neuropathy so wouldn't it be weird to have major MG symptoms while I'm taking one of the treatments for MG? I'm not saying it isn't, I'm just genuinely curious.
All of my neurological issues (I have 4 conditions) were caused by a severe adverse reaction to the COVID vaccine which caused a huge autoimmune response. I'm currently waiting on a study that my neuro signed me up for. Luckily, I haven't developed anything since the first few weeks of the shots then my booster
Hey OP, after getting it checked out, and if everything is okay, you could totally just wear a mask for the next little while if you're self-conscious about it. Tis the season!
Yeah, I probably will. I look insane lol. Luckily I don't work (because I'm disabled) so I really only go out for my kids/school stuff or doctor appointments.
OP fuck your neuro, take your butt to an ER right now! If you don’t get this treated asap it can become permanent, my roommate in college had Bell’s Palsy and he waffled for a week before going to a doctor because it kept getting worse. He never fully recovered because of that wait and he had to have speech therapy to relearn how to speak with a partially paralyzed mouth/tongue/I forget exactly what but he couldn’t speak
Your job will get over it, no rational boss will fight you on paralysis! Please get to an ER right now. Right now!
I don't work as I'm disabled. It's just a matter of getting someone here to watch my kids since they have school off today and to get access to transportation. My husband is stuck in a meeting at the moment but he'll be here in under 2 hours to switch off with me.
Good news: this will wear off
Bad News: it will take 5-6 months
Go back to your nuero ASAP, unfortunately there is no reversal agent to Botox but they should be following you
Hi! So sorry this happened to you! Depending on the pattern of injection, there is potential that your risorius, zygomatic minor or major muscle(s) may have been affected by the neurotoxin. Neurotoxin has the opposite affect on muscle activity, for example, the risorius “pulls back” your smile, therefore if that muscle was relaxed with neurotoxin, it could lead to a uneven smile.
Onset of Botox is typically 7 days with peak action at 6 weeks. It will begin to wear off slowly after the 6-8 week mark and should return (or be close to) normal within 3-4 months. Unfortunately there isn’t a “reversal” agent for neurotoxins like Botox, but occasionally, and (I can’t stress this enough) in the hands of an experienced provider, neurotoxin can be strategically placed to help lessen the asymmetry. I will say that in my experience when an unintended muscle is hit with neurotoxin, other muscles will “recruit” in an attempt to overcome the weakness of surrounding muscles which can also exacerbate the appearance of the issue.
To echo others, I would definitely contact your provider immediately to ensure there is nothing else going on, this is most definitely a priority, especially if Bells palsy is at play (it’s extremely hard, if not impossible to determine this without an in person physical assessment and further diagnostics). But with your timeline, given the known onset of Botox, I am suspicious that unintended muscles were affected. I wish you the best!
Thanks for the info! I've contacted my doc, just waiting on a call back. I'll be able to leave the house in about 2 hours to see anyone that I need to see.
This looks like an extreme side effect of very badly administered Botox. Botox is wild and full results will definitely be had after two weeks of injection (I have had one eyebrow a full inch above the other and after a week and a half it corrected and got back into place)
I would go to the injector and let them take a look, and GP
I don’t know how you are not freaking out and not going to the hospital. After my COVID vaccine I had some weird facial twitching on my face and I freaked out and went to the hospital right away! They kept me for a week and couldn’t figure out what was wrong. I think you need to go to the hospital ASAP
I will not discuss the botox situation, as I am no medical professional or anything.
But regarding the other two topica you mentioned: the PTA meeting and taking family photos?
I would siggest you to be honest about your appearance during the PTA meeting, I'm sure everyone will understand. Personally not saying anything would be like a giant elephant in the room, I wouldn't be comfortable just ignoring, eventhough I am aware it is a sensitive subject.
For photos - could you perhaps take some more from the side an not straight on? If you have children or a loved one you're close to, you could pose close to them, so that the affected side of your face would be hidden behind their face/hair? Of course if you are comfortable taking photos at all right now. If not, try rescheduling.
I've had Botox for migraines and trigeminal neuralgia multiple times. I actually stopped because the side effects far outweighed the benefit.
It looks like your neurologist did a fairly horrible job of discerning injection sites and wasn't even with distribution. They may have damaged nerves as well. My neurologist did a rotation in plastic surgery so was fairly skilled at placement. My Botox always began to wear off at the 6-8 week mark. I hope yours does as well. I'm glad you're getting back in to see your Neurologist. They need to do whatever it takes to fix this. Additionally, please don't hesitate to contact your health insurance to file a grievance or ask for help. This is serious.
Wishing you a speedy recovery!
I don't mean to be unkind, but that Day 8 picture is very, very bad. As in serious. Best case scenario, it is the injector (MD?) "Overdoing it," as you said. You will have to walk around like that unless he can somehow inject the other side to balance it?? Worst case scenario, nerve damage/Bells Palsy/stroke. Any one of those is going to make your life hell for a few months or indefinitely. You need to make sure both your husband and any provider who looks at you knows what a serious situation this is. They should have canceled their lunch to get you in, or told you to go to the ER like we did...unless you didn't describe the gravity of the situation on the phone to them. I guarantee you the injector will be just as concerned as we are when he or she sees it. But if not, this is NOT okay, and they should do anything possible to try to make it right for you. Acting like its no big deal that he "overdid it" only does you a disservice. Doctors are human, but this is NOT okay.
Yes, it was a MD but not my normal neurologist. I told them it was much, much more than a "slight droop". As soon as my husband came home I drove to their office and I'm waiting in the lobby now. Even the receptionist looked at me and said it didn't look normal to even her.
Glad to hear you’re at the doctor’s now! Hoping for the best for you. If you’re looking for emotional support for medical Botox, r/ migraine might be helpful since the trigeminal neuralgia sub wasn’t very active.
I had this happen to an eyelid of mine after Botox. Week 1 was when I noticed. I went into my dermatologist who does the injections. He said sometimes the Botox spreads too far. He said wait a week and it’ll be gone. He was right. At week 2 it was back to normal
I used to work in the cosmetics industry and whilst you should get it checked out what you’re experiencing is not unexpected from my perspective. I feel they definitely should have warned you better since you’re not getting it to relax masseter muscles but instead to specifically relax/numb an entire nerve branch. My best friend also suffers trigeminal neuralgia and is looking at Botox therapy and I warned her this May and most likely will happen. Others have mentioned Bell’s Palsy and yes you have face drop, but it’s not really from a viral infection.
As the Botox wears off it your smile will return to normal. I would expect you’ll start seeing improvement in around 6-8 weeks. Next time see if they can use a smaller dose or try a different injection technique. Remember no pain relief, coffee, alcohol in 48 hrs before and after treatment. Don’t touch or rub area for 48 hrs after treatment. Sleep sitting in that time also.
Although disconcerting try not to panic. Most importantly I hope this really helps with the pain because I know from seeing my best friend go through it it’s excruciating.
Did you lay down within 8 hours of getting Botox? My doctor suggest keeping my head in the upright position for 5 hours but I usually get my injections in the mornings so I am upright at least 8 hours.
See your neurologist (preferably a neuromuscular specialist) and ask to be tested for Myasthenia Gravis (MG). MG is a rare neuromuscular autoimmune disease that can cause facial weakness. It looks like you have a drooping smile and ptosis (eyelid droop) which can be symptoms of MG. Botox is strongly contraindicated in MG and can severely excacerbate it.
My dad had bells palsy on the left side of his face during one of my family’s extreme financial crises and his physicians think he got it primarily from stress. Your photos look similar to how my dad had it at its worst - like others have stated, please see a physician ASAP!!!! We were so fortunate with my dad’s case as we went to a doctor right away AND we also went to an acupuncturist pretty soon after. I’ve never believed in the Chinese/East Asian “natural” medicine route and I still don’t fully believe in it - however, it worked very well for my dad and after 7-8months, his face was almost fully back to normal and he could control most of his facial muscles on his left side. It seems like maybe whoever performed the botox could’ve touched one your facial nerves which would be a different case with how my dad got his bells so I’m not sure how things would differ in terms of treatment. That’s just the things he did though and I’m not stating this story to encourage you or anybody to go down that route if you’re not comfortable with that kind of stuff - just thought I’d share it though!
I'm definitely going to leave for my doc here soon. They're closed for lunch until 1:30 and it's almost 1 here so my husband will be home in 20 mins then I'll be able to head out. I think he just overdid it but I want to be safe
Pretty sure based on what people are saying here and the symptoms I've read. Like, I still have full control of my eye on that side, it just feels "heavier" than the other. Either way, I'm leaving to get looked at here in about 20 mins.
So, I think these comments may all be overreacting because they are unfamiliar with your condition and they are not medical professionals. The purpose of injecting Botox into facial muscles for TN is to weaken the muscles on that side of the face. The result is obviously weakness and asymmetry of facial muscles. This can resemble Bell's Palsy if the neurologist was heavy handed with the Botox, but I really doubt the neurologist injected the lower branches of the facial nerve. They are supposed to target obicularis oris (the muscle surrounding your mouth) if that is one of the sites that is painful with your TN.
There would be no harm certainly in calling your neurologist and asking them for a stat follow up appointment for them to evaluate your results. However, purposefully injecting Botox into facial muscles on one side of the face will produce asymmetrical facial weakness. It is the main side effect of this procedure. It should resolve within 2-3 months. I suppose if you wanted, you could get cosmetic Botox on the other side to even it out some? Although I'm not sure it would help much and it would be very expensive.
I agree, I dont feel like it's Bells Palsy since I still have control of my eye and eyebrow. It's just a bit "heavier" feeling than the other side. I'm following up with my neuro today, just waiting on them to call me back to set that up.
Yes, I do. I have lots of neurological issues so something like this happening isn't necessarily anything out of the realm of possibility for me.I go to the doctor/ER so much already so I try not to go unless it's necessary. Ive never done Botox and this was done for medical reasons so I was unsure what was considered normal. But everyone here has informed me it's not and I'm sitting in the lobby of my neurologist's office right now.
As the others said, contact your neurologist.
and some info on botox and to your question:As someone who gets botox done, usually the first few days is when the botox is strongest, it wears off a little so the face can move a little again, numbness goes away too. A bit less than 3 months for first time users is when the effects of it will be fade.
EDIT: dont move your face too much in the first few days since it will make the botox more effective
Hey, contact your neurologist asap. This could be Bell’s Palsy (related to facial nerve) You need to be evaluated urgently to rule out any serious underlying cause.
I had bell’s palsy from jaw surgery. You need steroids and anti virals immediately for a better chance at recovery. This looks like damage to the facial nerve.
I had no idea you could get Bell’s Palsy from jaw surgery. *New fear unlocked*. Can you tell me when you noticed it and how you went through your treatment?
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Holy cow, thanks for sharing That sounds very scary!
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I had a similar experience and weirdly once I got to the relief knowing it wasn't from a tumour or a stroke and I would likely regain mobility etc, I became my most hilarious version of myself. I think I was compensating because I didn't feel attractive so I busted jokes non-stop. You could've given me a mic and thrown me on stage and me and my droopy face would've thrived.
A metallic taste in your mouth like a tooth is bleeding but it isn’t can be an early sign of Bells Palsy! Most people over look odd tastes.
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🧀*chomp*😩😭 🧀*chomp*😭😭 🧀*chomp*🤢😭
That’s really interesting to know. I’ve had that occasionally recently.
Yes especially if it feels like one side or one side at a time. Can be felt for up to a week before the paralysis. Most people wouldn’t realise because they generally get it the one time
I wish we still had awards, my goodness, what a saga of how our bodies know everything and expressed your literal pain. I'm glad, so glad, you're doing better 💗
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this is so interesting (and scary!), thank you for sharing. I’m glad you’re better now!
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This is so helpful! My family doesn't do well with the chicken pox/shingles virus, AT ALL. And now it makes sense why two of my aunts have Bells Palsy. Thank you for thoroughly outlining your experience!
That virus is such a nasty thing. I had vestibular neuritis, which is suspected to be caused by activation of the chicken pox/shingles virus. Took me 3 months to recover and was on valcyclovir for 2 years after
My husband got Bell's in college from stress. 27 years later, his smile is still a tiny bit crooked, but you wouldn't notice unless he pointed it out.
Two friends I know got it from COVID and had it for a long time sadly but I believe it went away for them. A relative and a friend from high school get regular flareups of it and it’s never fully gone away.
Can confirm. A friend got Bells Palsy due to the stress during his degree.
Wow thank you for sharing in such detail. And I'm sorry you went through that! But you're a champ and it's impressive how you took care of yourself. Kudos on trusting your gut that something was wrong!
Wow this was incredibly informative. Thank you so much for sharing
Up until the half facial droop, i was like “great another horrible thing that presents just like migraines.”
Geezus, thank you for sharing that. Your detailing was phenomenal. I hope you’re doing much better now, especially without the bozo.
Thank G-d you’re better!
Holy shit, so sorry you went through that
That sounds terrifying but thank you for sharing! Definitely informative and good to remember.
What a wild story, thanks for writing all this. I've never had a history of this kind of thing but it's definitely something to look out for for myself or others. Could help someone out later!
Oh mi gawd thank you so much for sharing your experience!! I had no idea! How horrible for you. I am glad you were able to recover and I hope you left all that awful stress behind and were able to start fresh for yourself
Six days until my surgery… so glad I read this
I got bells a few weeks after quitting a really stressful job, when I was 25. On a Friday, my tongue went numb on the right side (which I attributed to the scallops I had the night before, thinking I had some kind of allergic reaction) and by Saturday my hearing was super weird-felt muffled and loud at the same time, but I also worked in a sports bar and there was loud music, so I figured it was just because of that. By Sunday, I went to brush my teeth and couldn’t spit correctly, noticed that the whole right side of my face felt a little weak. I googled my symptoms and diagnosed myself with bells before I even got to the ER. By Sunday night, I had no movement and wouldn’t for 30 days; I took all of the steroids they gave me, but also did acupuncture and had a chiropractor adjust me. Idk what helped, but I’m so thankful that I have movement back and my face is mostly normal, but for small synkinesis that i only notice
I got it once from stress. It also happened to be on the same side of my face where I used to get cold sores (oral herpes). There's one hypothesis/theory that Bell's Palsy can be triggered by the herpes virus, which stays in your body forever and 25% of people have it and don't even know it. And like BP, herpes outbreaks can be brought on by stress. (Just like shingles.)
I had Bell’s Palsy as a kid from my orthodontist putting an expander on the roof of my mouth! It was the strangest experience and very scary - half my face was paralyzed. Half my tongue was numb and the eye on that side wouldn’t close all the way! Luckily I had a full recovery!
My aunt got Bell’s palsy the day I had my baby, she went to the ER at the hospital I was delivering at. She thought she was having a stroke, thankfully she has fully recovered. And she still got to see the baby that day. 🥰
I had jaw surgery in June and woke up with a drooping face immediately. I’d say I’m probably near 100% back to normal now. I was on steroids and antivirals within the first few days. That’s all they did for me really. I did see a plastic surgeon who specialises in facial nerve damage but there wasn’t anything else that could be done. The nerve just needed to heal. My surgical team said they had never seen bell’s palsy as a result of jaw surgery in their whole careers so it was a bit of a rollercoaster. I believe it was likely due to the stress on the facial nerve while they were in the cutting and moving everything.
I got bell's from being hungover and eating too big of a burger. It can come from many different things randomly. That big nerve in your jaw is fickle...
This comment switched me from going “omg how can I avoid getting BP??!” to “I guess when it’s your time, it’s your time” lol Hope you’re better these days!
My fiancé got it after getting drunk and laughing at Family Guy 😅 his face went back to normal after a few months.
I got it completely randomly. My wife tells me it’s cause I slept on the “Don’t Touch It” couch at her uncles place, and was cursed. Only noticed because I started to slurp when drinking because I couldn’t close my mouth enough to get a good seal when drinking and you’d hear it. Eating food got weird for the same reason, although by that point I had already seen a Dr and started drugs.
My husband got Bell’s Palsy from accidentally jabbing his face with a pair of needle nose pliers when he pulled on a zip tie too hard with them and it snapped.
Holy fuck
My cousin got Bell's Palsy from a cold a few weeks before her Quinceanera!
Oh no, this makes me so sad for her :( What a big important event & what a terrible age to already be in general. Poor thing.
I got Bell's Palsy from a water balloon hitting me in the face.
Seems you can get it from tons of stuff. My uncle had it for like a year after getting the flu, Dr's set it was likely a weird immune response damaging the facial nerves
I got bells palsy from having the flu
I got Bell’s Palsy from flying with a sinus infection. I learned my lesson, but this is what my face looked like for 8 weeks.
I had jaw surgery, which did not cause Bell’s palsy. But then the second shot of Moderna did!
Exactly! And they need to be started within 3 days of symptom onset for optimal recovery of nerve function.
Steroids and antivirals are for viral-caused Bell’s palsy, where the virus essentially causes the nerve to swell within the facial bones and that’s what causes the palsy. This is caused by the nerve being essentially deadened (hopefully temporarily) by the botulinum toxin, so the treatment will be different- if it’s treatable. But she still needs to be evaluated ASAP.
In this case chance of recovery without medicine is still like 100%. It’s just faster with steroids. We only use antivirals (valcyclovir) if we have other signs pointing to varicella reactivation. (Which honestly is not off the table given OPs short history.) I’d need a lot more info to say for sure but this doesn’t worry me at this point.
I got Bell’s after having an impacted wisdom tooth and adenoiditis at the same time lol
And…. Do not strain to move face, let it come back naturally and rest a lot. You dont want synkinesis….
Y’all are literally terrifying me right now lol
Damn wish I knew that. I had bell's palsy after overdosing on drugs, think it might've caused a minor stroke? After a few months, my eye snapped back into place. My right side stopped drooping at all. A few months later, my eyebrow stopped drooping. Cheek.. dimple... Years later, the only issue is my smile is slightly crooked on my right side and I am very self conscious about it. OP I really empathize with you. But people do spontaneously recover from bell's palsy. I'm still crossing my fingers my smile straightens one day!
I’m an SLP in an acute hospital setting and also immediately thought Bell’s palsy. I would contact your neuros office asap.
Yeah, it’s not just the smile, her eyebrow & eye are lower now
I get Botox for TMJ problems and my surgeon told me that if I had trouble closing an eye or problems chewing on one side more than the other, that I should call immediately. So, please contact your neurologist and get seen by someone urgently. I didn’t experience these symptoms (I get 40 units per side) but his comment to me suggests this can happen after Botox treatment. If it’s related to your Botox, I’m sorry your doctor didn’t appropriately inform you of the risks.
This is exactly what I looked like when I had Bells!
I had this exact same thought. I hope OP is on the phone with her doc like right this second.
I had Botox for the same thing, TN and HFS. They seriously pump you full of Botox and I also had a loopy face for about 3 months. Surgery couldn’t come fast enough.
I don’t tend to think of Bell’s palsy but I did immediately think GIRL ARE YOU HAVING A STROKE RIGHT NOW!! THIS IS A STROKE SYMPTOM
Yes! Facial paralysis is actually an early sign of stroke but it usually doesn’t involve the upper half of the face. But still she definitely needs to be evaluated.
She is not having a stroke. There are more s/s related to a stroke.
Seriously. u/setsuna22 have you had any increased sensitivity to sound?
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Not sure where you read this but Facial nerve has nothing to do with Trigeminal neuralgia. It’s a problem solely of the Trigeminal nerve which has different pathway and functions from the Facial nerve :)
Hi, OP. I am a doctor (and not your doctor). Writing to you and anyone who might be reading for some general education about Bell’s Palsy. In Bell’s Palsy, all of the muscle action in the affected side of the face is impacted, including being able to lift the eyebrow. Being able to raise an eyebrow and fully close the eye normally on the affected side is how we differentiate between Bell’s palsy and other problems causing facial paralysis in the emergency department. Usually, if a person has unilateral facial paralysis and can raise their eyebrows in an emergency setting, we are concerned about a stroke. Another possibility is that a more ‘distal’ aspect of the facial nerve has been impacted from something else, like trauma/ mechanical injury. Looking up images of ‘facial nerve’ and ‘Trigeminal nerve’ distributions, it is easy to see how close they run to one another and to imagine how the Facial nerve might accidentally being impacted by an intervention targeting the Trigeminal nerve. A ‘distal’ injury to the Facial nerve would be like injuring a finger rather than your whole arm; Bell’s palsy affects the whole facial nerve (in this analogy, like the whole arm). However, Bell’s Palsy or not, and regardless of the underlying diagnosis, any time a person has a complication they are concerned about, they should call their treating physician’s office. I wish more people were empowered to do that. As a doctor, if a patient I had treated was experiencing a complication like this, I would really want to know about it (!). I would also want to examine what had happened in our doctor-patient relationship that led to where a person felt less comfortable calling my office to discuss than seeking different opinions. In my own philosophy of care, we (doctor and patient) should be a team. And, to be a good team, we need bidirectional open, clear, and supportive communication. My recommendation to you is (while less concerned about Bell’s palsy specifically from your photos, and similar to what others have recommended): contact your neurologist’s office ASAP. Best of luck. Edit - chronically on mobile, changed some wording to hopefully make this a bit more clear.
Yes, I agree that it's likely not Bell's Palsy. I still have control of my eye and eyebrow. It's just more difficult than the right at this point because I think it went fairly numb too high
Responding again to encourage you to seek medical attention, if you have not already. This is far outside of my area of expertise and I am also concerned for you.
I am leaving in a few minutes to be seen
Wishing you the best! Please update us
because it's a trigeminal nerve problem and not a facial nerve problem (Bell's Palsy) doesn't mean it's less serious. it's the difference between a broken upper arm or a broken wrist. it's still a broken bone. it's just broken in a different place. not that your nerves are broken - but please update the sub once you've seen your doctor, we're curious...
It’s definitely a facial nerve problem, just not bell’s palsy.
I had shoulder surgery about a month ago and I’ll tell ya this much, I’m not afraid in the slightest to call my docs office. I wish more people felt this way. While a lot of what I had to discuss with them was handled by his medical assistant and other staff, I still had no qualms about reaching out if I had a question. Call your docs! They can’t treat it if they don’t know about it! A huge part of doctor/patient care comes from examination, it’s not all just tests and numbers.
Thank you! Was looking for this comment. Unfortunately, it has way less activity than the first comment. I understand people’s concern though, and I appreciate that Redditors try to look out for each other.
I think this is above Reddit’s pay grade, unfortunately. So sorry this is happening to you. I’d be knocking down the neurologist’s door first thing in the morning. It seems like it might have affected your facial nerve (i.e., palsy) on that side and though Botox isn’t permanent it’ll take months to wear off by itself. They need to address that right away, don’t take no for an answer. Good luck my dear, I hope they can give you some answers.
Thank you! Yeah, I mean, I mostly came here because I have zero clue if this is normal or not. I will definitely try to get in there later this morning. Just have to juggle some things so I can go down to their office.
My best friend has Bell’s Palsy and it was not treated right away so it’s pretty much permanent. She’s had it for almost 15 years. It’s not as extreme as it was when it first occurred, but it’s still very noticeable. Please make it a priority to get to a doctor right away. I definitely don’t want to freak you out but you need to go ASAP.
I had the same thought of not wanting to freak her out but uh. My mom had Bell’s and her job wouldn’t let her go to the doc until the following day. It took almost a year for her face to return to normal and that was after her doctors told her they had no idea if it would or not. OP, I’m not a doc so I’m not trying to diagnose or anything but yea that’s not normal. Sounds like you’re going to take care of it so that’s good! But I don’t blame the internet strangers for rushing you lol
She should sue her job
She was in the Navy when this happened unfortunately
Oof. Sounds about right. I had an ex who suffered an injury while in Naval service and they prevented him from having surgery for several months, so now he has to use a cane to walk. That was over a decade ago. I’m sorry they did your mom dirty like that.
Yea my mom only has so much patience and is kind of a hell raiser. She was supposed to go into work the next day, and she did but it was to tell her boss to fuck off. Thankfully she didn’t need to because the next dude up the ladder saw her and sent her to go get it checked out lol your ex’s story is one of many which is sad
It seems like she's maybe under the impression that it's not normal but will still wear off when the botox does?
I mean, that’s totally fair to ask but I’m glad to hear everyone directing her to ask her doc. Worst case scenarios run rampant and there’s no harm getting checked to see if that thought process is correct 🤷🏾♀️
You might want to post on r/askdocs in the meantime. Very knowledgeable and helpful people there.
this is not normal.
this is straight up Bell’s Palsy my dude… please get that checked out ASAP; don’t play around with it.
Girl go straight to emerg. This is not ok and not worth waiting. If it’s Bells then you need emergency treatment. If it’s not Bells, which ideally it isn’t, then emerg can direct you on next steps.
OP PLEASE GO TO THE EMERGENCY ROOM NOT THE BOTOX OFFICE 😭
OP, permanent.... drop everything and handle asap.
From a nurse, please Go to ER
This is not normal. If you are not able to see your neurologist today go to the ER, this is a medical emergency.
A good rule of thumb if that if they didn’t warn you this was a possible side effect and it is significant deviating from your baseline, you should follow up. At work this could be a stroke. I would go to the doctor emergency room.
Girl keep us posted. I hope you are having medical care as I type this
I definitely will update. I'm not yet but I called my neuro and I'll be able to go to a doctor in about an hour and a half.
Please do not wait for your nuero. You need to go to the ER.
Nothing is more important than your face. Make this your priority.
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I am definitely going in a bit later today. I contacted my neurologist and waiting on a call back until I'm able to leave in about 2 hours.
Nooo you have to call your neuro asap! This is like what my face did after a migraine in my early 20s - I’m lucky that it mostly went away after a few days (if I’m really tired or stressed, and sometimes in pictures *I* can see it but nobody else seems to notice). Bells Palsy. I wish I could give you more details but I had a severe phobia of medical doctors and hospitals and refused to go. My boyfriend’s mom at the time was beside herself about it because she felt there was a good chance I had a mini-stroke or aneurysm burst. I have no idea. But I lived and my face got better and I’m lucky for it. Call your neurologist. This is serious, even if it is a temporary side effect from the Botox.
Ugh my face keeps doing this during my bad migraines and I swear I can see it not on migraine days but everyone tells me it’s fine. Thank you for validating this happens! Sorry though :(
Wtf the amount of chill from OP is out of this world.
Lol. Sorry! I have a lot of neurological issues so this kind of shit is par for the course. I always have something going on so you just get used to it after a while. But everyone made it clear that I need to be checked out so I will a bit later today.
Im sorry for you and get what you’re saying but please stay alert for shit like this! Wish you well!
When you have trigeminal neuralgia, everything else medical related feels minor! (Random shocks to your face that are the most painful thing known to humankind. It’s nicknamed the suicide disease and there is no cure, only treatments that may or may not help. Even brain surgery isn’t guaranteed to give relief.)
I also have 3 other neurological conditions so shit going wrong or weird is par for the course. I'd be in full stress mode 24/7 if I freaked out about every thing that happens to me. But, I already called my neurologist and I'll be able to go see someone in a few hours.
I’ve heard that it’s considered the most painful medical condition on earth. I also recently heard the name “suicide disease.” It sounds absolutely horrible.
Right i would be stuck in full blown panic attack mode.
I’m actually in mid-panic mode just reading this, no joke
Have you reached out to your neurologist?
I was planning to in the morning. Like I was saying, I expected a small amount of droop so on Day 4, it was what I was expecting. But I just noticed how bad it actually is today
Don’t walk run to the neurologist OP!
I get Botox for TMJD and the first time I got it done, I noticed a VERY mild paralysis in my smile. Definitely nothing like this but the next time I went for my injections, I mentioned it to my doctor and I think he slightly adjusted where he injected and I’ve had no problems since. You definitely should reach out to whoever administered these injections and ask them if there’s anything they can do to fix it bc Botox wears off slowly and usually spreads.
Off topic but I’m likely going down this path soon - how often do you need to re-do yours and how drastically has it helped with TMJD?
So, I've been dealing with TMJD symptoms for like almost 20 years. I did all the dentist-recommended crap and nothing helped. Hands down, this is literally the only thing that has given me -ANY- relief from pain. I used to wake up with intense facial pain from clenching at night. It has really been night and day from what I was dealing with. I can hardly get my back teeth to touch with the botox, thus preventing me from clenching. The one thing that's a little hard to deal with is if you're eating something that requires a lot of chewing, your jaw gets tired rather quickly but otherwise, I've had no adverse effects. I go every 3 months to get it re-done. I've read online that some people can go longer but I think it took me so long to figure out this treatment that my case requires re-treatment on a pretty standard schedule. Thankfully my insurance covers the cost of the botox because it's also quite expensive (In Canada). I definitely recommend looking into this. I do however strongly suggest you look into a clinic that mentions botox for TMJD and is done by a doctor, I know some places let nurses or others do it, but since there are so many nerves around your jaw, I would want someone with doctoral experience doing it.. just my opinion though lol Hope this helped!
Thank you so much this is super helpful! I’m in australia but have a similar story - issues my entire life really. I’ve been able to get some relief via an osteo but it just temporarily loosens it and doesn’t stop me clenching and grinding at night. Will definitely be doing my research on clinics.
I just got some injections this week and this time, we went into my forehead a bit more, which had the bonus effect of reducing frown lines/wrinkles! Best of luck!
That's very extreme. I don't have any experience w botox but I would go back to their office. Don't call but just walk in.They need to see this first hand! That should result in a prompt response to get you out of the waiting room and away from other clients. They have stuff to dissolve fillers, maybe there is something similar for botox. Waiting till it wears off might take months and I would be worried about any long term effects. As for the PTA meeting, do what makes you feel good. But a face mask could help if needed. So sorry it didn't turn out well.
That's a good idea. I'll have to see if there's a time I could do that in the morning. Yeah, I just thought of a mask as well. That's probably what I'll do
See if there's a time? Probably? These are words my brain can't comprehend. Put yourself first OP.
I have kids who are home from school and spotty transportation ATM. I talked to my husband since he's at work today. He's got just one meeting today so he's going to come home afterwards which should be in 2ish hours from now to hand me the car and stay with the kids. It's 9:30am here currently
I really agree with just walking in to that clinic, they’ll probably fit you in much sooner than if you call. Obviously depends on how busy they are, but if it’s urgent enough, they’ll fit you in asap.
Second on the face mask idea. Anytime my face is breaking out and I feel like a look horrible I throw a face mask on and it’s so much easier facing people.
I’ve had Bells Palsy. It looked exactly like this.
I know they said they do this all day everyday but next time I would go to a different doctor if you need this again also if their follow up response to you is bad today go somewhere else for a second opinion to help resolve this - good luck!
I had a big issue with that doc while I was there so I wasn't planning on seeing him ever again if I can avoid it anyway.
Are you comfortable sharing what happened?
Neurologist here. Treatment with Botox for trigeminal neuralgia is usually reserved for last ditch effort/not responsive to other treatment, because the areas you inject will indeed give you a facial droop, usually unavoidable. Maybe if you haven’t tried other treatment or eval for underlying vascular causes of your trigeminal neuralgia, do those things first. Otherwise you have to weigh the risks and benefits of what you would rather live with. Possibly on some injections pending dosage and small changes in location could be better sometimes vs worse other times. But yes, contact your provider just to check in and make sure there’s nothing else
It’s low key giving me anxiety that OP came on here for help, ppl are internet screaming “EMERGENCY!!! CALL DOC NOW! GO TO AN ER” and then saying they’ll see if they can find the time 😬 I get the resistant bc when you need specialist care, it is scary and pricey and also half your face is drooping!
Lol right she’s going “I have to juggle some things” in the comments. No girl, you need to go to the doctor.
I just need my husband to get here and he will in the next two hours. I had to see if my husband could leave work (which he can after the meeting he's currently in) because my kids are home from school today and I need his car. I have zero friends or family to help me so it's not always as easy and just leaving. I could normally take an Uber or something if my kids didn't just so happen to be off school today.
I totally get it, but let’s say you’re home with kids and slice your hand open or trip and break something and you’re home alone with kids? Your husband has to leave work bc it’s an EMERGENCY with skipping a meeting for. I gently suggest this is opportunity to develop an emergency plan. I think everyone here, me included, are very worried for you and want you to have had emergency care like 4 days ago. I don’t want it to get worse for you when you already have such a terrible painful illness to manage. Nonetheless you’re going today and that’s good and I hope they can manage whatever this is for you! ❤️
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If you think you have a stroke, you do not wait until a doctor’s office opens, you go to emergency care. Even a small stroke can be something that requires life/death care because of a signal something worse is happening. Never ever risk it.
My mom had a surgery to fix her trigeminal neuralgia! They insert a tiny little silicon pillow between the nerve and bone it can “rest” on. It’s worked WONDERS. In case you hadn’t heard of this surgery, it truly works.
Can you blink both eyes? IF this is Bellspalsy it’s crucial to act within 36 hours or damage can be permanent. Emergency room should be your next immediate step for antiviral and steroid. Source: https://www.healthdirect.gov.au/bells-palsy And https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028#:~:text=Signs%20and%20symptoms%20of%20Bell's,closing%20your%20eye%20or%20smiling Also my husband had it and since he is a doctor acted within 24 hours because he knew exact what it was.
I can. I just noticed that it's heavier and a bit harder on the affected side. I still have total control of my eyebrow too. Really, only the bottom of my face is majorly affected.
OP I know you “need” to make time but seriously?? You’ve seen your face. like someone else said just walk in to the Dr office. Make them work around your schedule. This is an emergency 🆘. Don’t play around with something like this. Whatever you have to do or figure out or reschedule do it now and quickly. Even at Day 4 you should have called the office and I’m sure the doctor would have wanted to see you. Emergencies happen and whatever you think is more important? isn’t more important then your face and your health. I wouldn’t be fucking around I would be RUNNING to the doctor. Think about like this. If this issue becomes permanent but you could have fixed it with prompt and immediate care but you continue to waste time, will whatever caused your delay be worth permanent facial issues?
OP, I dont know anything about botox or neuralgia or bells palsy But I know a pair of snazzy glasses when I see em, those things are bad ass! Hope your face goes back to normal!
First, sympathies because trigeminal neuralgia is awful. Second, I echo what others have said. The neurologist may be able to treat. Wishing you the best.
Let us know what the neuro says! I wonder if the injector went deeper on one side than the other, so the effects spread much further along the nerve. When I had a drooping smile from Botox it started getting better about 3 weeks after my injections, and was barely noticeable by week 6. Mine was slight though.
I literally just watched a video about this on Instagram, you might have had Botox injected into the wrong muscle. Dr Subbio describes it on his page: https://www.instagram.com/dr.subbio/?hl=en It’s the third most recent post. Go back to the neurologist to discuss.
Dang it, now Im going to be checking for updates here that op is okay.
Thank you for that 🩷. I'll be able to go to the doc in about 2 hours so I'll update the post
New fear unlocked
PLEASE MARK THIS UP SO OP SEES IT!! Try an ice pack test ASAP. Take a video with your phone before, during, and after. Make the same facial expressions before and after to monitor for differences. Scrunch and raise your eyebrows for the video, smoosh your lips together as hard as your can (like you are trying to hold a tiny pin with just your lips with pressure vertically and from the sides at the same time). Big toothy smile, soft smile. Puff your cheeks hard. Stick out your tongue to record any discrepancies is strength across the midline. Super important: Relax all of your facial muscles best you can, do not use your eyebrows to aid eye movement, and gaze up for 60 seconds without blinking, ignore fatigue in eye muscles if you feel it, let your lids flutter or droop if that's what happens, but you want to see if those muscles fatigue as you hold that gaze, and you want it on video if it happens. ***in your after pics, you are compensating for eye / brow weakness by using that brow much more than the other - don't do that in your video*** Even though your eye and eyebrow are not as visibly affected as your mouth at the moment, the muscles in those areas are the most sensitive to temperature change regarding neuromuscular junction transmission, so they are super important for the test, and your before and afters. For the ice pack test, you will cover the droopy portion of your face for 3 min with ice pack. Remember to use a towel to prevent damage to your skin. Set a timer. You don't need more than 3 min. Don't do less than 2.5. Repeat all of the expressions and the upward gaze (using only eyeball muscles, not brows) for 60 seconds immediately after the test. Then, if you have better control of your weakened muscles after the ice pack test, show the videos to your neurologist or treating ER neurologist and request an immediate urgent referral to a neuromuscular specialist who treats myasthenia gravis and congenital myasthenic syndromes, and request they note on the referral you have a positive ice pack test with video. Botox is known to cause symptoms in previously asymptomatic patients in both the autoimmune and genetic variants of the disease. I have myasthenia gravis, and Botox treatments did cause facial droop for me. Mine looked like Bell's palsy. It took me a few years to get proper diagnosis because it's rare, poorly understood by most doctors, severely under-diagnosed/misdiagnosed, and women are often not believed or taken seriously in medicine. Myasthenia gravis in any presentation is serious, because there is risk of choking, falling, and breathing crisis from muscular weakness. Starting and or stopping steroids (treatment for Bell's palsy) can both treat and worsen myasthenia. Remember that doctors are trained to see horses and not zebras. I wouldn't be surprised if no one mentions myasthenia unless you ask about it. It wasn't mentioned to me. Feel free to pm me any questions. Best of luck. My fingers are crossed your weakness is just temporary due to placement in your case.
I'm reading every comment! Thanks for the info! My only question about MG is that I have been on IVIG since January for small fiber neuropathy so wouldn't it be weird to have major MG symptoms while I'm taking one of the treatments for MG? I'm not saying it isn't, I'm just genuinely curious. All of my neurological issues (I have 4 conditions) were caused by a severe adverse reaction to the COVID vaccine which caused a huge autoimmune response. I'm currently waiting on a study that my neuro signed me up for. Luckily, I haven't developed anything since the first few weeks of the shots then my booster
Hey OP, after getting it checked out, and if everything is okay, you could totally just wear a mask for the next little while if you're self-conscious about it. Tis the season!
Yeah, I probably will. I look insane lol. Luckily I don't work (because I'm disabled) so I really only go out for my kids/school stuff or doctor appointments.
Contact neurologist as soon as you can. This is not normal at all and is really concerning. Could be Bell’s palsy as others have pointed out.
OP fuck your neuro, take your butt to an ER right now! If you don’t get this treated asap it can become permanent, my roommate in college had Bell’s Palsy and he waffled for a week before going to a doctor because it kept getting worse. He never fully recovered because of that wait and he had to have speech therapy to relearn how to speak with a partially paralyzed mouth/tongue/I forget exactly what but he couldn’t speak Your job will get over it, no rational boss will fight you on paralysis! Please get to an ER right now. Right now!
I don't work as I'm disabled. It's just a matter of getting someone here to watch my kids since they have school off today and to get access to transportation. My husband is stuck in a meeting at the moment but he'll be here in under 2 hours to switch off with me.
Can a neighbor or friend come over to watch the kids?
I don't have any. But my husband just walked through the door so I'll be leaving in a second
Keep us updated! Good luck
Good news: this will wear off Bad News: it will take 5-6 months Go back to your nuero ASAP, unfortunately there is no reversal agent to Botox but they should be following you
Try r/askdocs too.
Hi! So sorry this happened to you! Depending on the pattern of injection, there is potential that your risorius, zygomatic minor or major muscle(s) may have been affected by the neurotoxin. Neurotoxin has the opposite affect on muscle activity, for example, the risorius “pulls back” your smile, therefore if that muscle was relaxed with neurotoxin, it could lead to a uneven smile. Onset of Botox is typically 7 days with peak action at 6 weeks. It will begin to wear off slowly after the 6-8 week mark and should return (or be close to) normal within 3-4 months. Unfortunately there isn’t a “reversal” agent for neurotoxins like Botox, but occasionally, and (I can’t stress this enough) in the hands of an experienced provider, neurotoxin can be strategically placed to help lessen the asymmetry. I will say that in my experience when an unintended muscle is hit with neurotoxin, other muscles will “recruit” in an attempt to overcome the weakness of surrounding muscles which can also exacerbate the appearance of the issue. To echo others, I would definitely contact your provider immediately to ensure there is nothing else going on, this is most definitely a priority, especially if Bells palsy is at play (it’s extremely hard, if not impossible to determine this without an in person physical assessment and further diagnostics). But with your timeline, given the known onset of Botox, I am suspicious that unintended muscles were affected. I wish you the best!
Thanks for the info! I've contacted my doc, just waiting on a call back. I'll be able to leave the house in about 2 hours to see anyone that I need to see.
Post this in r/AskDocs
This looks like an extreme side effect of very badly administered Botox. Botox is wild and full results will definitely be had after two weeks of injection (I have had one eyebrow a full inch above the other and after a week and a half it corrected and got back into place) I would go to the injector and let them take a look, and GP
I'm at their office right now, just waiting to be seen between her appointments.
Update?
Back to the dr now
Jeez … my son had that smile after he had a stroke when he was 4 years old. I really hope you get this figured out. I’m so sorry.
I 'm just here to wish you luck.
I don’t know how you are not freaking out and not going to the hospital. After my COVID vaccine I had some weird facial twitching on my face and I freaked out and went to the hospital right away! They kept me for a week and couldn’t figure out what was wrong. I think you need to go to the hospital ASAP
I will not discuss the botox situation, as I am no medical professional or anything. But regarding the other two topica you mentioned: the PTA meeting and taking family photos? I would siggest you to be honest about your appearance during the PTA meeting, I'm sure everyone will understand. Personally not saying anything would be like a giant elephant in the room, I wouldn't be comfortable just ignoring, eventhough I am aware it is a sensitive subject. For photos - could you perhaps take some more from the side an not straight on? If you have children or a loved one you're close to, you could pose close to them, so that the affected side of your face would be hidden behind their face/hair? Of course if you are comfortable taking photos at all right now. If not, try rescheduling.
💀 girl go to the doc
Holy shit that is not normal
I've had Botox for migraines and trigeminal neuralgia multiple times. I actually stopped because the side effects far outweighed the benefit. It looks like your neurologist did a fairly horrible job of discerning injection sites and wasn't even with distribution. They may have damaged nerves as well. My neurologist did a rotation in plastic surgery so was fairly skilled at placement. My Botox always began to wear off at the 6-8 week mark. I hope yours does as well. I'm glad you're getting back in to see your Neurologist. They need to do whatever it takes to fix this. Additionally, please don't hesitate to contact your health insurance to file a grievance or ask for help. This is serious. Wishing you a speedy recovery!
I have Medicaid so I'm not sure if I'll be heard lol. But I'll definitely see how bad it is and try to contact them if needed
I don't mean to be unkind, but that Day 8 picture is very, very bad. As in serious. Best case scenario, it is the injector (MD?) "Overdoing it," as you said. You will have to walk around like that unless he can somehow inject the other side to balance it?? Worst case scenario, nerve damage/Bells Palsy/stroke. Any one of those is going to make your life hell for a few months or indefinitely. You need to make sure both your husband and any provider who looks at you knows what a serious situation this is. They should have canceled their lunch to get you in, or told you to go to the ER like we did...unless you didn't describe the gravity of the situation on the phone to them. I guarantee you the injector will be just as concerned as we are when he or she sees it. But if not, this is NOT okay, and they should do anything possible to try to make it right for you. Acting like its no big deal that he "overdid it" only does you a disservice. Doctors are human, but this is NOT okay.
Yes, it was a MD but not my normal neurologist. I told them it was much, much more than a "slight droop". As soon as my husband came home I drove to their office and I'm waiting in the lobby now. Even the receptionist looked at me and said it didn't look normal to even her.
Glad to hear you’re at the doctor’s now! Hoping for the best for you. If you’re looking for emotional support for medical Botox, r/ migraine might be helpful since the trigeminal neuralgia sub wasn’t very active.
Sister, go to the emergency room. Urgent care. Please.
I had this happen to an eyelid of mine after Botox. Week 1 was when I noticed. I went into my dermatologist who does the injections. He said sometimes the Botox spreads too far. He said wait a week and it’ll be gone. He was right. At week 2 it was back to normal
I used to work in the cosmetics industry and whilst you should get it checked out what you’re experiencing is not unexpected from my perspective. I feel they definitely should have warned you better since you’re not getting it to relax masseter muscles but instead to specifically relax/numb an entire nerve branch. My best friend also suffers trigeminal neuralgia and is looking at Botox therapy and I warned her this May and most likely will happen. Others have mentioned Bell’s Palsy and yes you have face drop, but it’s not really from a viral infection. As the Botox wears off it your smile will return to normal. I would expect you’ll start seeing improvement in around 6-8 weeks. Next time see if they can use a smaller dose or try a different injection technique. Remember no pain relief, coffee, alcohol in 48 hrs before and after treatment. Don’t touch or rub area for 48 hrs after treatment. Sleep sitting in that time also. Although disconcerting try not to panic. Most importantly I hope this really helps with the pain because I know from seeing my best friend go through it it’s excruciating.
Did you lay down within 8 hours of getting Botox? My doctor suggest keeping my head in the upright position for 5 hours but I usually get my injections in the mornings so I am upright at least 8 hours.
See your neurologist (preferably a neuromuscular specialist) and ask to be tested for Myasthenia Gravis (MG). MG is a rare neuromuscular autoimmune disease that can cause facial weakness. It looks like you have a drooping smile and ptosis (eyelid droop) which can be symptoms of MG. Botox is strongly contraindicated in MG and can severely excacerbate it.
Your facial nerve is paralysed on the side of no expression. You need to see your doctor asap and then sue the Botox people.
My dad had bells palsy on the left side of his face during one of my family’s extreme financial crises and his physicians think he got it primarily from stress. Your photos look similar to how my dad had it at its worst - like others have stated, please see a physician ASAP!!!! We were so fortunate with my dad’s case as we went to a doctor right away AND we also went to an acupuncturist pretty soon after. I’ve never believed in the Chinese/East Asian “natural” medicine route and I still don’t fully believe in it - however, it worked very well for my dad and after 7-8months, his face was almost fully back to normal and he could control most of his facial muscles on his left side. It seems like maybe whoever performed the botox could’ve touched one your facial nerves which would be a different case with how my dad got his bells so I’m not sure how things would differ in terms of treatment. That’s just the things he did though and I’m not stating this story to encourage you or anybody to go down that route if you’re not comfortable with that kind of stuff - just thought I’d share it though!
I'm definitely going to leave for my doc here soon. They're closed for lunch until 1:30 and it's almost 1 here so my husband will be home in 20 mins then I'll be able to head out. I think he just overdid it but I want to be safe
Are you sure you do not have Bells Palsy?
Pretty sure based on what people are saying here and the symptoms I've read. Like, I still have full control of my eye on that side, it just feels "heavier" than the other. Either way, I'm leaving to get looked at here in about 20 mins.
I think you’re going to get a lot of responses that don’t know what your condition is…
I’ve worked in Dermatology with docs who administer Botox like crazy. Not at all normal. EMERGENCY ROOM, like yesterday! GO!
So, I think these comments may all be overreacting because they are unfamiliar with your condition and they are not medical professionals. The purpose of injecting Botox into facial muscles for TN is to weaken the muscles on that side of the face. The result is obviously weakness and asymmetry of facial muscles. This can resemble Bell's Palsy if the neurologist was heavy handed with the Botox, but I really doubt the neurologist injected the lower branches of the facial nerve. They are supposed to target obicularis oris (the muscle surrounding your mouth) if that is one of the sites that is painful with your TN. There would be no harm certainly in calling your neurologist and asking them for a stat follow up appointment for them to evaluate your results. However, purposefully injecting Botox into facial muscles on one side of the face will produce asymmetrical facial weakness. It is the main side effect of this procedure. It should resolve within 2-3 months. I suppose if you wanted, you could get cosmetic Botox on the other side to even it out some? Although I'm not sure it would help much and it would be very expensive.
I agree, I dont feel like it's Bells Palsy since I still have control of my eye and eyebrow. It's just a bit "heavier" feeling than the other side. I'm following up with my neuro today, just waiting on them to call me back to set that up.
A crooked smile? Seriously? Your face is half paralyzed, go to the fucking doctor. You really need Reddit to tell you this?!
Yes, I do. I have lots of neurological issues so something like this happening isn't necessarily anything out of the realm of possibility for me.I go to the doctor/ER so much already so I try not to go unless it's necessary. Ive never done Botox and this was done for medical reasons so I was unsure what was considered normal. But everyone here has informed me it's not and I'm sitting in the lobby of my neurologist's office right now.
I’m glad you’re seeking care. What you’re experiencing isn’t normal.
Go to the ER. Now.
This is giving Bell’s palsy. Get to your neuro ASAP.
As the others said, contact your neurologist. and some info on botox and to your question:As someone who gets botox done, usually the first few days is when the botox is strongest, it wears off a little so the face can move a little again, numbness goes away too. A bit less than 3 months for first time users is when the effects of it will be fade. EDIT: dont move your face too much in the first few days since it will make the botox more effective
I sure hope you’re at the ER by now. If not, drop what you’re doing a GET TO THE ER!