botulinum toxin therapy for cervical dystonia.
Article 1 of two
Department of Neurology, Hospital Universitari
La Fe, Valencia, Spain.
A 40-year-old man with cervical dystonia
developed an acute inflammatory demyelinating
polyradiculoneuritis after botulinum toxin type
A treatment. Some cases of idiopathic brachial
plexopathy and polyradiculoneuritis have been
reported to date. Although a causal relationship
is not firmly established, the clinical temporal
profile suggests a pathogenic relationship. In
patients with cervical dystonia, further use of
type A botulinum toxin should be considered
contraindicated, and the use of another type of
botulinum toxin should be taken into
Article 2 of two
Rinsho Shinkeigaku. 2004
A case report of acute polyradiculoneuritis
developing after multiple injections of
botulinum toxin for cervical dystonia
Department of Internal Medicine, Section of
Neurology, Saga Medical School.
A 68-year-old man receiving four times of
injection of botulinum toxin type A for cervical
dystonia developed acute polyradiculoneuritis 10
weeks after the final injection. He had been
complaining of paresthesia in four limbs after
the second injection of the treatment. On
neurological examination, bilateral facial
palsy, bulbar palsy, difficulty of breath,
flaccid paralysis of all limbs, sensory
disturbance of all modality and areflexia in all
limbs, and positive Laseque sign were noted.
Albuminocytological dissociation was present in
the CSF and the conduction velocity was
significantly impaired in all peripheral nerves
examined. After receiving two times of
intravenous highdose IgG and two times of pulse
therapy, his neurological deficits gradually
improved. To our knowledge, this is the third
case report of acute polyradiculoneuropathy
developing after botulinum toxin therapy,
suggesting that botulinum toxin therapy is
involved in the pathogenesis in our case.
PMID: 15199733 [PubMed - indexed for MEDLINE]
Clin Neuropharmacol. 2000 Jul-Aug;23(4):226-8.
Click to view different size nerve fibers.