Undesirable Distant Effects Following Botulinum Toxin Type A Injection

Roche, Nicolás; Schnitzler, A.; F, François Genêt; Durand, Marie-Christine; Bensmaïl, Djamel

doi:10.1097/wnf.0b013e31815cba8a

Cited by 49 publications

(49 citation statements)

References 23 publications

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“…This technique is used for the diagnosis of foodborne botulism and also the systemic diffusion of BoNTA. [14][15][16][17][18][19] The aim of this study was to investigate signs of BoNTA diffusion in patients with weakness in a muscle distant from the injection site or with fatigue. For that purpose, SFEMG was carried out in striated muscles distant from the injection site.…”

mentioning

confidence: 99%

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Ruet

Durand

Denys

et al. 2015

Archives of Physical Medicine and Rehabilitation

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mentioning

confidence: 99%

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Ruet

Durand

Denys

et al. 2015

Archives of Physical Medicine and Rehabilitation

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“…Two of these adverse events were severe, since the patients complained of diffuse muscle weakening with inability to walk. One of them was hospitalized for a prolonged time [39]. …”

Section: Pharmacovigilancementioning

confidence: 99%

Serious and Long-Term Adverse Events Associated with the Therapeutic and Cosmetic Use of Botulinum Toxin

Yiannakopoulou

2015

Pharmacology

103

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Although botulinum toxin is generally considered safe, its widespread use and the constantly expanded indications raise safety issues. This study aimed to review the serious and long-term adverse events associated with the therapeutic and cosmetic use of botulinum toxin. Serious adverse events included dysphagia, respiratory compromise, generalized muscle weakness, marked bilateral ptosis, pseudoaneurysm of the frontal branch of the temporal artery, necrotizing fasciitis, sarcoidal granuloma, Fournier gangrene, and cervical kyphosis. Death was attributed to botulism or anaphylactic shock. In conclusion, botulinum toxin may cause serious adverse events, which are more common after its therapeutic use, but can also be noticed after its cosmetic use. Thorough knowledge of the anatomy of the treated muscles and of the pharmacology of the drug is imperative to avoid serious adverse events.

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“…But a volume effect on the diffusion of BoNT is reported (an increase of BoNT efficacy is highlighted by an EMG test on animals when they receive an injection with a higher volume for the same dosage. On human patients, an increased surface action of BoNT is highlighted when a higher volume is injected for the same dosage [30,31]. The dose effect on migration is uncertain and remains highly controversial [7,13].…”

Section: Discussionmentioning

confidence: 99%

Intra Detrusor Botulinum Toxin and Lower Limbs Motor Deficit: About 2 Clinical Cases

Khenioui¹,

Berre²

2016

J Clin Case Rep

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Objective: To demonstrate how a single intra detrusor botulinum toxin injection could be responsible for lower limbs proximal motor deficit.Results: Two women-37 and 38 years old-presenting with secondary progressive multiple sclerosis, having received intra detrusor botulinum toxin injections (400 BOTOX® U and 750 DYSPORT® U) due to major neurogenic detrusor over activity with high-pressure and risks of uro-nephrologic complications despite an efficient-dose anticholinergic bi-therapy (DITROPAN®/CERIS®). Few days in post-injection they present heavy tiredness, instability of the pelvis, and a major reduction of the walking distance. Those symptoms last for several months. During the emergency neurology consultation set up in the event of a new relapse, an aggravation of the paraparesis at the proximal level is observed. This deficit accounts for the realization of a corticosteroids bolus, the effectiveness of which is questioned by the patient. A cerebral and medullary MRI is performed in order to certify the appearance of new lesions. The MRI doesn't objectify any new lesions or any pathological contrast enhancement.Discussion: Ramirez-Castaneda et al. describe three means of dissemination of the BoNT: migration by systemic or neuronal transport, propagation/spread and diffusion. Conclusion:The retrograde migration of the botulinum toxin via hypo-gastric nerves seems to prevail. It could be followed by axonal anterograde transport causing a deficit on the hip flexors via the L2 nerve root.

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Undesirable Distant Effects Following Botulinum Toxin Type A Injection

Abstract: Diffusion diagnosis of BoNTA from the injection site depends on clinical, temporal, and electromyographic factors. Clinical expression of spread varies widely, with mechanisms remaining largely unknown, and further prospective, randomized clinical trials are required.

Cited by 49 publications

References 23 publications

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Single-Fiber Electromyography Analysis of Botulinum Toxin Diffusion in Patients With Fatigue and Pseudobotulism

Serious and Long-Term Adverse Events Associated with the Therapeutic and Cosmetic Use of Botulinum Toxin

Intra Detrusor Botulinum Toxin and Lower Limbs Motor Deficit: About 2 Clinical Cases

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