Espinosa Neuroscience Institute

What a night at Inter Miami yesterday! Watching Inter Miami vs. FC Cincinnati from the first row and seeing Messi, the GOAT, that close was unforgettable. Thank you to my friend Chris Salamone for the first-row tickets, and to my beautiful daughter Yairita, my soccer pal, for sharing it with me. ❤️⚽

The Botox Paradox

In my article "The Botox Paradox," published in Cureus, I wrote about a problem I live every day in practice.

Botox works. For chronic migraine, for dystonia, for spasticity — I've seen it change patients' lives.

But here's the paradox: a treatment that works is a treatment many patients can't afford. The copays, the coverage fights, the surprise bills. Patient after patient came back unhappy — not with the treatment, but with the cost of getting it.

So we made a hard call: our practice stopped offering Botox.

That didn't make anyone happier either. Patients who finally found something that worked were told we couldn't offer it anymore — not because it didn't help, but because the economics were broken.

That's the paradox. Effective care that patients can't access isn't really access at all.

But there is reason for hope. Ipsen just announced positive top-line results for Dysport in two phase III trials covering 1,510 patients, with both hitting their primary endpoints. Dysport would be the first botulinum toxin ever to show efficacy in episodic migraine — the far larger group that Botox was never approved to treat.

More competition in this space is exactly what could finally bring drug prices down. That's good for patients, and it's what would let practices offer these treatments again without losing money on every one.

Reimbursement should cover the medication, the staff time, and the overhead — and still leave a reasonable margin. Competition getting us there would resolve the paradox.

Read the full article here: https://www.cureus.com/articles/505639-the-botox-paradox-how-rising-drug-costs-and-reimbursement-failures-threaten-access-to-botulinum-toxin-therapy-in-neurology

What an amazing evening at The Colony Palm Beach! 🚀 It was a privilege to hear Jeff Hessel present "NASA Space Race: The History of Cape Canaveral — Eye Witness View." His firsthand, eye-witness perspective brought the early days of the space program to life in a way no textbook ever could. Thank you to the World Affairs Council of Palm Beach for an unforgettable night. 🌙✨

A lovely follow-up to our thank-you last week 💐

Antonia Markakis stopped by the office, and we got to thank her in person for the beautiful orchids — and take a picture together.

Antonia, we are so thankful to know you and your family. Your kindness and friendship mean the world to us.

With gratitude,
Espinosa Neuroscience Institute
Patricio Sebastian Espinosa
Espinosa Neuroscience Institute

Grateful for friends like Larry and Roberta Helfant. Roberta hand-made this framed portrait of me, and it now hangs proudly on the wall at the office. Thank you, Roberta, for such a thoughtful gift. 🙏

Your brain deserves VIP treatment. 🧠

Experience a new standard of concierge neurology in Boca Raton — meet Dr. Espinosa, tour the space, and explore membership at the Espinosa Neuroscience Institute.

📞 561-788-7545 Espinosa Neuroscience Institute
🌐 EspinosaHealthcare.com
Private tours available.

September is World Alzheimer's Month. 💜

As a neurologist, this fight is personal. Memory is identity — and there is more we can do to protect it than most people realize: stay active, stay connected, sleep well, control blood pressure.

What's the one question about brain health you've always wanted to ask? Ask me below. 👇



https://www.facebook.com/cien.ecuador/

Our concierge practice in Boca Raton provides personalized care for memory concerns, migraines, neuropathy, multiple sclerosis, movement disorders, myasthenia gravis, dizziness, complex neurological conditions, and second opinions.

Explore the new website and request a private consultation:
https://espinocare-kdcu8jmr.manus.space/

Patricio Sebastian Espinosa

The Espinosa Neuroscience Institute extends its heartfelt condolences to Lionel Messi and the entire Messi family following the passing of his beloved father, Jorge Messi.

May the cherished memories, love, and legacy they shared bring comfort and strength during this profoundly difficult time.

Our thoughts and prayers are with the Messi family.

Rest in peace, Jorge Messi. 🕊️
Patricio Sebastian Espinosa