title: Generalised muscular weakness after botulinum toxin injections for dystonia: a report of three cases.
abstract: Three patients are reported on who developed transient generalised weakness after receiving therapeutic doses of botulinum toxin for cervical dystonia (one case) and symptomatic hemidystonia (two cases) respectively. Clinical and electrophysiological findings were in keeping with mild botulism. All patients had received previous botulinum toxin injections without side effects and one patient continued injections without recurrence of generalised weakness. The cause is most likely presynaptic inhibition due to systemic spread of the toxin. Patients with symptomatic dystonia may be more likely to have this side effect and botulinum toxin injections in these patients should be carried out cautiously.
authors.affiliation: Department of Clinical Neurology, Institute of Neurology, University College, London, Queen Square, London, UK.
authors.forename: K P
authors.initials: KP
authors.lastname: Bhatia
authors.forename: A
authors.initials: A
authors.lastname: Münchau
authors.forename: P D
authors.initials: PD
authors.lastname: Thompson
authors.forename: M
authors.initials: M
authors.lastname: Houser
authors.forename: V S
authors.initials: VS
authors.lastname: Chauhan
authors.forename: M
authors.initials: M
authors.lastname: Hutchinson
authors.forename: A H
authors.initials: AH
authors.lastname: Shapira
authors.forename: C D
authors.initials: CD
authors.lastname: Marsden
mesh_terms: D000328:Adult; D001905:Botulinum Toxins / Q000009:adverse effects* / Q000627:therapeutic use; D004421:Dystonia / Q000188:drug therapy*; D004576:Electromyography; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology*
chemical_list: D001905:Botulinum Toxins