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If the patient is getting worse then toxicity is a concern

10.3390/ijms160511196 44 HrelecM.KlicekR.BrcicL.BrcicI.CvjetkoI.SeiwerthS.et al (2009)

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And also I wouldn't have a patient have Botox on the, sometimes they just tap and add Botox where the, whenever there's pain, if you do that, you're not finding the cause of the pain