Iatrogenic botulism after botulinum toxin type A: Five cases

Botulinum toxin A (BTX-A) is frequently used for spasticity, focal dystonia, hemifacial spasm, hyperhidrosis, strabismus, chronic migraine and cosmetic purposes. Therapeutic use is generally safe. It is important to consider the risk of iatrogenic botulism, especially in high dose approved or with unapproved formulations and indications. Five patients with iatrogenic botulism were described. All patient developed systemic symtomps of Botulism following botulinum toxin injection for various reason. Clinical presentatiton, treatment and outcome were explained in this report. Conclusion: Based on the case series reported, we would like to emphasize the important of adhering to recommended dose of approved formulations approved or unapproved indication of BTX-A.