Systemic adverse events after botulinum neurotoxin A injections in children with cerebral palsy

Paget, Simon P; Swinney, Caitlyn M; Burton, Karen; Bau, Karen; O'Flaherty, Stephen

doi:10.1111/dmcn.13995

Cited by 32 publications

(34 citation statements)

References 26 publications

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“…In 2005, the FDA reported 36 adverse effects related to cosmetic use, which met the FDA's definition of serious adverse events, with the majority concerning dysphagia [6]. Serious adverse effects after cosmetic use of botulinum toxin include dysphagia, muscle weakness, and allergic reactions [22,23]. Dysphagia and muscle weakness are common symptoms of botulism.…”

Section: Serious Adverse Effectsmentioning

confidence: 99%

The whole truth about botulinum toxin – a review

Witmanowski¹,

Błochowiak²

2020

pdia

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Treatment with botulinum toxin is widely viewed as safe, effective and largely devoid of serious side effects. There are two classes of Botox-related adverse events-transient and benign events, and potentially serious events. The aim of this study was to provide an overview of Botox-related side effects and advise potential management and preventive strategies. Benign side effects are well-localized, reversible and self-limited complications which develop within a few days of the injection, and they usually disappear without any treatment. The aesthetic and functional adverse effects are associated with different muscle responses to botulinum toxin or with misplacement of botulinum toxin. The serious events are sequelae due to the systemic spread of toxin leading to botulism.

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Section: Serious Adverse Effectsmentioning

confidence: 99%

The whole truth about botulinum toxin – a review

Witmanowski¹,

Błochowiak²

2020

pdia

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“…In children, injections are typically performed using sedation and/or general anaesthetic. Children with severe CP, particularly those with impaired swallow, may be at increased risk of adverse events following BoNT‐A.…”

Section: Symptomatic Therapiesmentioning

confidence: 99%

Current therapies and therapeutic decision making for childhood‐onset movement disorders

2019

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Movement disorders differ in children to adults. First, neurodevelopmental movement disorders such as tics and stereotypies are more prevalent than parkinsonism, and second, there is a genomic revolution which is now explaining many early‐onset dystonic syndromes. We outline an approach to children with movement disorders starting with defining the movement phenomenology, determining the level of functional impairment due to abnormal movements, and screening for comorbid psychiatric conditions and cognitive impairments which often contribute more to disability than the movements themselves. The rapid improvement in our understanding of the etiology of movement disorders has resulted in an increasing focus on precision medicine, targeting treatable conditions and defining modifiable disease processes. We profile some of the key disease‐modifying therapies in metabolic, neurotransmitter, inflammatory, and autoimmune conditions and the increasing focus on gene or cellular therapies. When no disease‐modifying therapies are possible, symptomatic therapies are often all that is available. These classically target dopaminergic, cholinergic, alpha‐adrenergic, or GABAergic neurochemistry. Increasing interest in neuromodulation has highlighted that some clinical syndromes respond better to DBS, and further highlights the importance of “disease‐specific” therapies with a future focus on individualized therapies according to the genomic findings or disease pathways that are disrupted. We summarize some pragmatic applications of symptomatic therapies, neuromodulation techniques, and some rehabilitative interventions and provide a contemporary overview of treatment in childhood‐onset movement disorders. © 2019 International Parkinson and Movement Disorder Society

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“…Other possible pathways towards severe outcomes were discussed such as the drugs utilized for sedation or anaesthesia and various comorbidities including epilepsy. 3,4 The prospective observational study by Paget et al 5 demonstrates another important aspect of this problem. It shows that specific vulnerabilities of patients even with less severe involvement (such as dysphagia and/or history of aspiration pneumonia) are a source of concern.…”

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confidence: 99%

“…The prospective observational study by Paget et al . demonstrates another important aspect of this problem.…”

mentioning

confidence: 99%

“…1 I agree with the conclusion of Paget et al that the occurrence of significant negative health consequences after BoNT-A treatment is not common. 5 However, the potential risk for systemic adverse events should always be considered, particularly in severely involved patients but also in the presence of dysphagia, respiratory disorders, and other comorbidities.…”

mentioning

confidence: 99%

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