The Walton Centre NHS Foundation Trust (WCFT) provides a Regional botulinum toxin service for Neurorehabilitation and in many neurological conditions. These include spasticity, hemifacial spasm, focal dystonias affecting the eyes (blepharospasm), face, jaw, neck (cervical dystonia) and limbs (eg writer’s cramp), drooling, migraine and s

  The Walton Centre NHS Foundation Trust (WCFT) provides a Regional botulinum toxin service for Neurorehabilitation and in many neurological conditions. These include spasticity, hemifacial spasm, focal dystonias affecting the eyes (blepharospasm), face, jaw, neck (cervical dystonia) and limbs (eg writer’s cramp), drooling, migraine and some pain other conditions. We see patients mainly from Merseyside and North Wales. We liaise with many other toxin users in the Region, such as in ENT, paediatrics, orthopaedics.

We have a strong record in research and innovation, having been pioneers in the use of botulinum toxin since 1987 when it first became available. We link with toxin services around the UK through the British Neurotoxin Network (BNN) and internationally for collaborative research and training through Dystonia Europe, and the Movement Disorder Society.

The service is part of a broader movement disorder, neurorehabilitation and pain service at WCFT with medical and surgical expertise in other advanced treatments such as deep brain stimulation (DBS), apomorphine, duodenal gel infusion, and baclofen pumps.  

The LIVErpool botulinum toxin chart or LIVEchart is a simple ‘Patient Reported Outcome Measure (or ‘PROM’) that we have used and honed over 30 years to monitor the effects of botulinum toxin injections. 

It is valid for any toxin indication and can easily be used for multiple indications in the same patient. It will also work for almost

The LIVErpool botulinum toxin chart or LIVEchart is a simple ‘Patient Reported Outcome Measure (or ‘PROM’) that we have used and honed over 30 years to monitor the effects of botulinum toxin injections. 

It is valid for any toxin indication and can easily be used for multiple indications in the same patient. It will also work for almost any cyclical treatment, such as regular nerve blocks.

It consists of a single sheet covering one injection cycle. We give it to the patient or carer at each toxin treatment clinic. They complete it weekly, and bring it at the next treatment clinic.

For the patient it provides greater understanding of their treatment and allows them to describe the good and any bad effects in each cycle, and to contribute to treatment decisions.

For clinicians it speeds up clinics, and greatly simplifies the task of optimising toxin treatments, including when multiple conditions have been treated. It can avoid the need for interim clinic visits. It provides a complete record, on one sheet, of the treatment given and its effects.

For toxin services, management and funding agencies, it provides data from the patients themselves to ensure due diligence and operational effectiveness.

For trainees it provides direct feedback and facilitates learning.

For researchers it provides a unique tool for comparing injection regimes and outcomes 

You can download it from the link below. There are also links to instructions and advice for using it, and a training video which clinicians, patients and carers can watch.

Please remember it is copyright, in order to protect its integrity.

The COVID-19 crisis has created enforced gaps in regular botulinum toxin treatment cycles.

Mind the Gap is a collaborative project which aims to use a service evaluation of this unique natural experiment to learn how to deal with the service disruption if there is a second wave, and to explore the ways in which botulinum toxin works and 

The COVID-19 crisis has created enforced gaps in regular botulinum toxin treatment cycles.

Mind the Gap is a collaborative project which aims to use a service evaluation of this unique natural experiment to learn how to deal with the service disruption if there is a second wave, and to explore the ways in which botulinum toxin works and possibly influences the course of diseases. 

The essence of Mind the Gap is simplicity for clinicians, by using the routine data from LIVEchart, collected up by many toxin services and sent electronically to be aggregated for analysis. This tool provides a unique way of comparing the effects of COVID-19 and interactions with botulinum toxin across multiple diseases.