Bulbar Muscle Weakness in the Setting of Therapeutic Botulinum Injections

Abstract

We present a case of new-onset bulbar muscle weakness in the setting of therapeutic botulinum injections for spasticity in a teenaged patient with cerebral palsy. Through a careful history, a systemic effect of the local injections was suspected, and the patient’s symptoms improved with a decrease in the dosing of the botulinum injections.

Alternative Methods for Testing Botulinum Toxin: Current Status and Future Perspectives

“…Botulinum toxins can cause a rare but life-threatening condition called botulism, characterized by weakness, blurred vision, speech impairment, muscle cramps, vomiting, diarrhea, and fever. The estimated human lethal dose of botulinum toxins is 1.3-2.1 ng/kg when administered by the intravenous or intramuscular route and 10-13 ng/kg when administered by the inhalation route (Alshadwi et al, 2015;Lentz and Weingrow, 2018).…”