Document Detail


Systemic weakness after therapeutic injections of botulinum toxin a: a case series and review of the literature.
MedLine Citation:
PMID:  20852412     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The use of intramuscular injections of Botulinum neurotoxin A (BoNT-A) is common in the treatment of hypertonicity and movement disorders. Although most side effects are mild, systemic effects, manifested by generalized weakness distant from the site of injection, have been reported. Previously reported occurrences are discussed, and 3 new cases of patients, who developed systemic weakness after administration of BoNT-A (Botox), despite having tolerated similar injections on several previous occasions, are presented. A review of the literature and reported cases indicate that risk of developing systemic effects does not seem to be related to dose based on body weight. It may be more likely that risk for systemic effects is related to total injection dose and injection frequency. The results of our 3 patients would indicate that injections of greater than 600 units of Botox with follow-up injections occurring every 3 months may lead to an increased risk. We would recommend careful consideration of reinjection frequency if injections of greater than 600 units of Botox are given. Reduction in systemic side effects may occur if reinjection frequency occurs in intervals of 4 months or greater in these individuals.
Authors:
Beth E Crowner; Diego Torres-Russotto; Alexandre R Carter; Brad A Racette
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Clinical neuropharmacology     Volume:  33     ISSN:  1537-162X     ISO Abbreviation:  Clin Neuropharmacol     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-01-06     Revised Date:  2013-06-14    
Medline Journal Info:
Nlm Unique ID:  7607910     Medline TA:  Clin Neuropharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-7     Citation Subset:  IM    
Affiliation:
Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Dyskinesia Agents / adverse effects*,  contraindications,  therapeutic use
Botulinum Toxins / adverse effects*,  contraindications,  therapeutic use
Dose-Response Relationship, Drug
Dystonia / drug therapy*,  physiopathology
Electromyography
Female
Humans
Injections, Intramuscular
Male
Muscle Weakness / etiology*,  physiopathology
Young Adult
Grant Support
ID/Acronym/Agency:
1K08NS064365-01A1/NS/NINDS NIH HHS; 5T32NS007205-27/NS/NINDS NIH HHS; K08 NS064365/NS/NINDS NIH HHS; K24 ES017765/ES/NIEHS NIH HHS; K24ES017765/ES/NIEHS NIH HHS; KL2 RR024994/RR/NCRR NIH HHS; KL2RR024994/RR/NCRR NIH HHS; T32 NS007205/NS/NINDS NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1RR024992/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Dyskinesia Agents; EC 3.4.24.69/Botulinum Toxins
Comments/Corrections

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