title: Serious and long-term adverse events associated with the therapeutic and cosmetic use of botulinum toxin.
abstract: Although botulinum toxin is generally considered safe, its widespread use and the constantly expanded indications raise safety issues. This study aimed to review the serious and long-term adverse events associated with the therapeutic and cosmetic use of botulinum toxin. Serious adverse events included dysphagia, respiratory compromise, generalized muscle weakness, marked bilateral ptosis, pseudoaneurysm of the frontal branch of the temporal artery, necrotizing fasciitis, sarcoidal granuloma, Fournier gangrene, and cervical kyphosis. Death was attributed to botulism or anaphylactic shock. In conclusion, botulinum toxin may cause serious adverse events, which are more common after its therapeutic use, but can also be noticed after its cosmetic use. Thorough knowledge of the anatomy of the treated muscles and of the pharmacology of the drug is imperative to avoid serious adverse events.
authors.affiliation: Faculty of Health and Caring Professions, Technological Educational Institute of Athens, Athens, Greece.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Yiannakopoulou
mesh_terms: D000818:Animals; D001905:Botulinum Toxins / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D006801:Humans; D060735:Pharmacovigilance
chemical_list: D001905:Botulinum Toxins