Ptosis as a remote effect of therapeutic botulinum toxin B injection
The authors report a patient with cervical dystonia, previously treated with botulinum toxin A (BTX-A), who developed bilateral ptosis and difficulty with accommodation only after botulinum toxin B (BTX-B). High-frequency repetitive nerve stimulation of the abductor digiti minimi demonstrated a 34% increment in compound muscle action potential. No increment in 20 people injected with BTX-A and no cases of ptosis in a chart review of 1,606 BTX-A injections for cervical dystonia were found. The authors conclude that systemic spread of BTX-B can cause symptomatic involvement of autonomic neurons.
Medical Subject Headings
Adult; Anti-Dyskinesia Agents (adverse effects); Blepharoptosis (chemically induced, diagnosis); Botulinum Toxins (adverse effects); Botulinum Toxins, Type A (adverse effects); Electromyography; Female; Humans; Neuromuscular Agents (adverse effects); Retrospective Studies; Torticollis (drug therapy)
Digital Object Identifier (DOI)
Racette, B A.; Lopate, G; Good, L; Sagitto, S; and Perlmutter, J S., "Ptosis as a remote effect of therapeutic botulinum toxin B injection" (2002). Neurology. 1170.