Madarosis and Facial Alopecia Presumed Secondary to Botulinum A Toxin Injections

The document reported a case of unilateral left-sided madarosis and facial alopecia in a patient receiving botulinum A toxin injections for left oromandibular dystonia. The patient, who had been undergoing treatment for 18 months with injections every 3 months, first noticed the loss of his left sideburn 8 months into the treatment and later observed that he no longer needed to shave the left side of his face. After 18 months, madarosis of the temporal aspect of the left lower lid was noted. This case was significant as it was the first to document these specific adverse side effects presumed to be secondary to botulinum A toxin injections.