Ask My Doctor Tool

Question 1:

Which condition have you been diagnosed with?

Adult upper limb spasticity: muscle tightness in the hands and arms

Cervical dystonia: abnormal head position and neck pain

Blepharospasm: abnormal eyelid spasms

Question 2:

What are your symptoms? (Select all that apply)

Head turning/tilting/jerking

Neck turning/tilting/jerking

Head shaking

Neck shaking

Neck pain/stiffness

Shoulder pain/stiffness

List any additional symptoms here.

Question 2:

What are your symptoms? (Select all that apply)

Involuntary eyelid movement

Excessive blinking

Light sensitivity

Dry eyes

Eye irritation

Watering eyes

List any additional symptoms here.

Question 2:

What are your symptoms? (Select all that apply)

Muscle stiffness (known as hypertonia)

Limited range of movement

Reduced ability to relax muscles

Muscle spasms

Changes in limb position


List any additional symptoms here.

Question 3:

Given your current symptoms, are you able to complete the daily activities that you enjoy:

Most of the time

Some of the time



List the activities (if any) that you have difficulty completing/enjoying here.

Question 4:

Which treatment(s) are you receiving for your condition or have received in the past? (Select all that apply)

Botox® (onabotulinumtoxinA)

Dysport® (abobotulinumtoxinA)

Myobloc® (rimabotulinumtoxinB)

I have not been treated for my condition


Write any additional notes about your treatment history here.

Question 5:

How satisfied are you with your current treatment on a scale of 1–5?

1 (very dissatisfied)




5 (very satisfied)

Not applicable

Write any additional notes about your current treatment here.

My questions today are:

  • Based on this information, what are my treatment options for my condition?
  • What do I need to do to make the switch to a new treatment?
  • What can I expect from my possible new treatment(s)?
  • Who can I talk to about co-pay or other support programs for possible new treatments?

Write any additional questions you may have here.

XEOMIN is an FDA-approved neurotoxin therapy used to treat adults with upper limb spasticity, cervical dystonia, and those with blepharospasm who have been treated previously with Botox®(onabotulinumtoxinA).

A personalized discussion guide has been created for you based on your responses. You can take this guide to your next doctor’s appointment to help you talk to your doctor about your symptoms decide and if XEOMIN is right for you.

Now that you’ve completed your personalized discussion guide, click one of the links below to explore this site and get more information about XEOMIN:

Learn about the XEOMIN purification process

Find out what you can expect from treatment with XEOMIN

Read about the financial assistance available for XEOMIN