Abstract

Iatrogenic botulism – a possible cause of generalised muscular weakness in child

Highlights

  • Botulinum toxin (BT) has been used for long time for treatment of different neuromuscular disorders like dystonia, spasticity, spasmodic torticollis, blepharospasm, hemifacial spasm, strabismus

  • The exact dose of botulinum toxin A recommended for treatment of lower limb spasticity in children with cerebral palsy is not clearly specified

  • After 1 week she presented with weekness, generalized muscular hypotonia, loss of head control, poor sitting, reduced movements, right palpebral ptosis, dysarthria, difficulty in swallowing, feeding and speech disorder and drooling. Her mother had an unsurveilled pregnancy and the child was spontaneously delivered at 26-week gestation, weighting 995 grams and with APGAR score of 4 at 1 minute and 8 at 5 minutes

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Summary

INTRODUCTION

Botulinum toxin (BT) has been used for long time for treatment of different neuromuscular disorders (either at manufacturer-recomandation or in off-label indications) like dystonia, spasticity, spasmodic torticollis, blepharospasm, hemifacial spasm, strabismus. Over the last few years the indications for BT toxin use have extended for cosmetic applications (rejuvenation therapy and hyperhidrosis), treatment for chronic migraine, sialorrhea, neurogenic and nonneurogenic bladder dysfunction. The exact dose of botulinum toxin A recommended for treatment of lower limb spasticity in children with cerebral palsy is not clearly specified. This should be individualized and estimated according to size of the muscle, severity of spasticity, previous botulinum toxin injections and patient response or adverse reactions. Repeat treatment should be administered no sooner than 12 weeks after the previous injection

CASE PRESENTATION
CONCLUSIONS

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