Iatrogenic botulism in a child with spastic quadriparesis.
Botulinum toxins are potent neurotoxins used in a variety of neurological disorders. Few pediatric reports have been published to date regarding the potential hazards of therapeutic use of botulinum toxins. We describe the case of a 10-year-old boy who developed systemic weakness following treatment of spasticity with botulinum toxin type B. The patient developed iatrogenic botulism with ptosis, facial diplegia, neck flexor and extensor weakness, and profound hypopharyngeal laxity with respiratory compromise from which he eventually recovered. Clinicians should be mindful of the risk for systemic botulism when using local injections of the neurotoxin.
Partikian
Arthur
A
Pediatric Neurology Division, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. apartiki@usc.edu
Mitchell
Wendy G
WG
D001905:Botulinum Toxins / Q000009:adverse effects* / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A; D001906:Botulism / Q000139:chemically induced* / Q000503:physiopathology; D002648:Child; D018450:Disease Progression; D006801:Humans; D007049:Iatrogenic Disease; D007821:Laryngeal Muscles / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D018908:Muscle Weakness / Q000139:chemically induced / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000187:drug effects / Q000503:physiopathology; D010608:Pharyngeal Diseases / Q000139:chemically induced / Q000503:physiopathology; D011782:Quadriplegia / Q000188:drug therapy*; D020127:Recovery of Function; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000503:physiopathology; D012891:Sleep Apnea Syndromes / Q000139:chemically induced / Q000503:physiopathology
C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A