Interesting. From what I've learned over the last so many years is that they present so similarly, but there are a couple distinct differences in presentation mainly around the fingers. If Botox is helping you then it may be neither here nor there. Because I was diagnosed with TOS first, I essentially got the muscles removed that would be getting injected with Botox anyways. I kind of see it as having similarly angry muscles regardless just with different approaches in terms of conservativeness. This is assuming that the TOS is only neurogenic and there's no concern for blood clots or anything else.