Migraine – Botox – And Funny Eyebrows

Have you ever wondered why some people who have had Botox (botulinum toxin A) treatment have strange looking eyebrows?

Botox and Mr. Spock Eyebrows

It’s called the Mephisto Sign, or perhaps Mr. Spock Eyebrows.  Basically, one or both eyebrows arch, making the patient look – surprised, all the time.  And they probably are.

This is a possible problem for migraine patients when they receive injections in the forehead.  What happens is, the frontalis muscle of the forehead becomes hyperactive, causing the eyebrows to arch.  You can see an example of the Mephisto sign from Botox here.

Fortunately, even if this happens it can usually be fixed.  Another injection to the lateral-most point (the outer part) of the frontalis muscles should fix the problem, although you may still be waiting a few days.

Although a pretty minor problem compared to chronic migraine pain, the Mephisto sign can be a pretty annoying problem, as well as a dead giveaway that someone has had Botox treatment, for whatever reason.

It’s just another reminder that you need to make sure you’re going to a specialist experienced in Botox (or Dysport or Xeomin) migraine treatment.  Make sure they keep a careful record of exactly where you have been injected each time.  And do return to them if you have any problems with your treatment, including eyebrows that won’t behave.

Here’s some more information about How to be Safe with Botox (10 tips).

Also see A proposal to prevent the “mephisto sign” side effect of botulinum toxin type a injection in chronic migraine.