[Frequency of side effects after botulinum toxin A injections in neurology, rehabilitation and gastroenterology].
Botulinum toxin type A is one of the most potent biological toxins, recently used clinically (Botox, Dysport) for wide range of indications. THE AIM OF THE STUDY was to assess the frequency and severity of side effects during BTX-A therapy for different indications and underlying possible mechanisms.


METHODS
Material consisted of 327 patients (F202, M125) who underwent 1043 sessions of BTX-A injections for: cervical dystonia--CD (n=58), blepharospasm--BLP (n=31), hemifacial spasm--HFS (n=39), spasticity due to cerebral palsy--CP (n=96), chronic anal fissure--CAF (n=96), esophageal achalasia--AE (n=7).


RESULTS
In CD the following side effects were observed: dysphagia (27% of patients and 7% of sessions), weakness of neck muscles (6.7% and 1.3%), pain during swallowing (5.1% and 1%), flu-like syndrome (3.4%, 0.7%). Dysphagia appeared 8.2 days after injection and lasted 14.9 days on average. In BLP authors noticed: unilateral ptosis (22%, 6.3%), bilateral ptosis (3%, 1.9%), haematoma (3%, 0.6%) and in HFS: excessive weakness resulting in asymmetry of face--mild (28.2% and 20%) and moderate (46% and 26.7%). In spasticity due to CP authors noticed: excessive weakness of lower limbs which lasted 13.8 days on average (6.2% and 1.9%), pain (5.2% and 1.6%), flu-like syndrome (4.1% and 1.3%). In CAF: mild incontinence of the flatus and faeces (9% and 5% of sessions), haematoma (5%), flu-like syndrome (3%), inflammation of external anal varices (2%), epididymitis (1%). In AE: chest pain in 6 (at the day of injection and lasted 2-4 days) and reflux in 2 patients (4-8 weeks after injection, lasted 2-3 weeks) were observed.


CONCLUSIONS
Therapy with BTX-A is a very safe procedure, especially when compared with high rate of effectiveness of injections. The side effects are transient, mostly local and completely reversible.
Sławek
Jarosław
J
Klinika Neurochirurgii, Oddział Neurochirurgii Czynnościowej i Chorób Układu Pozapiramidowego Akademii Medycznej w Gdańsku. jaroslawek@amg.gda.pl
Madaliński
Mariusz H
MH
Maciag-Tymecka
Iwona
I
Duzyński
Wojciech
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001763:Blepharoptosis / Q000139:chemically induced*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000139:chemically induced*; D020821:Dystonic Disorders / Q000188:drug therapy; D004931:Esophageal Achalasia / Q000188:drug therapy; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy; D019569:Hemifacial Spasm / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy; D018908:Muscle Weakness / Q000139:chemically induced*; D009132:Muscles / Q000187:drug effects*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A