Atypical Hypersensitivity Reaction to Botulinum Toxin Injection / Reação de hipersensibilidade atípica à injeção de toxina botulínica

Botulinum toxin type A (BTA) injection, marketed as BOTOX, is commonly used as a treatment for a variety of clinical indications and is widely viewed as safe, effective and largely devoid of serious side effects. Anaphylactic reactions to BTA are typically unheard of in the scientific literature. BOTOX is approved by the Food and Drug Administration for the treatment of cervical dystonia and prophylaxis for chronic migraines. This case report documents a unique instance of allergic reaction to BTA in a 29-year-old woman with cervicogenic headache and cervical dystonia who reported immediate flushing, light-headedness and nausea after receiving BTA injections.

A injeção de toxina botulínica tipo A (BTA), comercializada como BOTOX, é comumente usada como tratamento para uma variedade de indicações clínicas e é amplamente considerada segura, eficaz e amplamente desprovida de efeitos colaterais graves. As reações anafiláticas ao BTA são normalmente inéditas na literatura científica. BOTOX é aprovado pela Food and Drug Administration para o tratamento de distonia cervical e profilaxia de enxaquecas crônicas. Este relato de caso documenta um caso único de reação alérgica ao BTA em uma mulher de 29 anos com dor de cabeça cervicogênica e distonia cervical que relatou rubor imediato, tontura e náusea após receber injeções de BTA.

Botulinum Toxin For Treatment Of Migraine Headaches - A Study From Tertiary Eye Care Centre

Background - Migraine is one of the common causes of recurrent headaches. Botulinum toxin type A (Botox®) is a neurotoxin produced by Clostridium botulinum that paralyzes nerves. The purpose of this study was to evaluate the efficacy of pericranial Botox® administration in migraine headache in patients attending a tertiary eye care centre. Method - A prospective, non-randomized study consisting of 54 patients was performed. Subjects were candidates who either sought Botox® treatment for hyperfunctional facial lines with concomitant headache or candidates for Botox® treatment specifically for headaches. Headaches were classified based on International Headache Society criteria. Botox® was injected into the glabellar, temporal, frontal, and/or suboccipital regions of the head and neck. Patients were treated every three months, with a maximum of three sessions. Botox dosage ranged from 75 - 155 Units per patient. Main outcome measures were relief from migraine headache symptoms, reduction of headache severity and duration of symptom free period. Age ranged from 18 to 65 (mean 34.6±6.5) years. Among 54 subjects treatedResults - prophylactically, complete response (symptom elimination) was noted in 31 (57.40%) with a mean {Standard deviation – (SD)} response duration of 4.3 (2.4) months; 16 (29.62%) reported partial response (?50% reduction in headache frequency or severity) with a mean (SD) response duration of 2.5 (1.7) months. 7 (12.96%) reported no response. No systemic adverse effects were reported. Botox® is found to be a safe and effective therapy for prophylacticConclusion - treatment of migraine.

Two cases of sporadic severe food-borne botulism / 中华全科医师杂志

Two female patients with acute onset of sporadic food-borne botulism are reported. Both patients presented cranial nerve palsy symptoms and rapidly involving respiratory muscles causing respiratory failure. The tracheal intubation, mechanical ventilation and active supportive measures were given at admission. The skull imaging and cerebrospinal fluid examination were negative, and the electromyography showed peripheral motor nerve damage. One patient was complicated with severe pneumonia. The botulinum toxin test was positive, and botulism poisoning was diagnosed. After early targeted treatment, patients were improved and discharged. Both patients had no complications and recurrence after discharge in 8 months of follow-up.

Botulinum neurotoxin a for hand tremors in Parkinson’s disease: A meta-analytic study

Background@#Resting tremor is a prominent cardinal motor symptom of Parkinson’s disease (PD). In some cases, the tremor may be refractory to dopaminergic and anticholinergic treatment. Multiple studies were previously done to evaluate the effectiveness of Botulinum Neurotoxin A (BoNT/A) with essential tremors and dystonia, but data regarding its use on tremors of PD is still lacking. @*Objective@#This meta-analytic study aims to determine the effectiveness of BoNT/A in treating tremors of patients with PD. @*Data Sources@#Data Sources: Researches were searched at PubMed, ScienceDirect and EBSCO Host. @*Review Methods@#Articles on the effect of BoNT/A on PD hand tremors were searched. Studies and data pertaining to non-PD tremors like essential tremors excluded in the analysis due to difference in pathophysiology. Standardized mean difference was used as the effect measure and was computed with Review Manager version 5.4 software. @*Results@#Three open label studies were used for final analysis in this study. Studies included are those pertaining to tremors due to PD. Pooled estimates showed a significant change in decreasing tremor score after BoNT/A injection. @*Conclusion@#Botulinum Toxin A injections can be used to manage PD tremors effectively.

Awareness of Botox Injections in Facial Aesthetics among Dental Students

The aim of this study was to evaluate the awareness and knowledge on the use of Botox injections in facial aesthetics among undergraduate dental students. Botulinum toxin is considered as a quick and effective non-surgical solution for enhancing physical appearance. Botox is considered as the best choice, as it is affordable and less radical than surgery. It is derived from gram-positive spore forming, clostridium botulinum. A questionnaire was developed to evaluate the awareness of dentists towards using botulinum toxins in facial aesthetics. The survey was conducted online via survey planet. There were about 103 study population, participated in this study. Data is collected using an online survey planet link and statistically analysed. 95.1% of participants reported that they have general knowledge on the Botox (95.1%). 66 % of respondents agreed that clostridium botulinum bacterium is the source of Botox. 24.51% of respondents stated that Botox was commonly used for wrinkle reduction and 96.1% were aware of the toxicity effect of Botox when it is administered in a high dosage. Association between response of the participants and knowledge on Botox was found to be statistically significant (p<0.05). According to our study, the majority of students showed an acceptable level of knowledge and awareness on Botox and its use in facial aesthetics

Eight years experience with botulinum toxin A and eyelid surgery in the treatment of hemifacial spasm / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To report the therapeutic outcomes of botulinum toxin A(Botox)and eyelid surgery in patients with hemifacial spasm(HFS).<p>METHODS: Patients' images and medical notes were retrospectively reviewed with subsequent analysis of both the therapeutic outcomes and complications of Botox injections. <p>RESULTS: The information of 76 patients(Female=58)with HFS who received a minimum of 4 Botox injections were included. The mean follow-up interval was 83±50(20-112)mo with an average of 16±10(4-34)injections. The peak incidence was between 55 and 64 years and the average age of onset was 66±11(32-85)years. Up to 23% of patients with HFS had aberrant vascular structures(Right=8, Left=7)in close relationship to the facial nerve(MRI=14, CT=1), where the vertebral artery(<i>n</i>=6)was the most involved vessel followed by the anterior inferior cerebellum artery(<i>n</i>=5). Patients with primary HFS had a shorter effective duration(2.5 <i>vs</i> 3.1mo, <i>P</i><0.05), a longer onset time(4.1 <i>vs</i> 3.8d, <i>P</i>=0.739)and a lower Subjective Spasm Alleviation score(SSAs)(1.7 <i>vs</i> 1.9, <i>P</i>=0.179)than those with secondary HFS. Twelve of the 19 patients with pre-existing eyelid diseases underwent surgical correction including upper blepharoplasty(<i>n</i>=12), limited myectomy(<i>n</i>=7), browplasty(<i>n</i>=7)and advancement of levator aponeurosis(<i>n</i>=5). Five(41.7%)of those with surgical correction and suboptimal response to Botox showed improvement 6mo after surgery \〖onset time(<i>P</i>=0.0256), effective duration(<i>P</i>=0.374)and SSAs(<i>P</i>=0.0161)\〗. Those 12 patients with eyelid surgery had a lower complication rate than those without eyelid surgery(23% <i>vs</i> 42%, <i>P</i>≤0.05).<p>CONCLUSION: Botox is an effective and safe treatment for HFS. We found that patients with primary HFS had a less favorable therapeutic outcome with Botox than those with secondary HFS. Eyelid surgery for patients with concurrent eyelid diseases can augment the effect of subsequent Botox injections by improving patient satisfaction and reducing complication rate.

Ultrasound-guided greater occipital nerve block with botulinum toxin for patients with chronic headache in the occipital area: a randomized controlled trial / 대한마취과학회지

BACKGROUND: Ultrasound-guided greater occipital nerve (GON) block has been frequently used to treat various types of headaches, and botulinum toxin has recently begun to be used in patients with headache. Our study presents the long-term effect of botulinum toxin on GON block using ultrasound in patients with chronic headache in occipital area. METHODS: Patients with occipital headache were divided into two groups (bupivacaine: BUP group [n = 27], botulinum toxin: BTX group [n = 27]), and ultrasound-guided GON block was performed at the C2 level. GON was detected with ultrasound and distance from GON to midline, from the skin surface to GON, and size of GON were measured in both groups. Visual analogue scale (VAS) scores and Likert scale were assessed at pretreatment and at 1, 4, 8, and 24 weeks after treatment in both groups. RESULTS: The distance from GON to midline was 18.9 ± 4.4 mm (right) and 17.3 ± 3.8 mm (left). The depth from the skin was 12.9 ± 1.5 mm (right) and 13.4 ± 1.6 mm (left). GON size was 3.1 mm on both sides. The VAS score and patient satisfaction score (Likert scale) in 4, 8, and 24 weeks after injection were superior for the BTX than the BUP group. CONCLUSIONS: Ultrasound-guided GON block using BTX is effective in reducing short-term and long-term pain in patients with chronic headache in the occipital area.

Botox treatment for TMJ-TMD and Migraine pain / Шинэ санаа Шинэ нээлт

@#TMJ is a mobile organ that participatesin speaking , chewing , swallowing and other regular movements. Its special characterization and other causes lead to disorders which progress into TMD & headache and those are one of the major concerns of the modern-day1-5.TMJ pain should be differentiated from migraine dependent pain and in both cases Botox injection has recently shown good results. Our study goal was to study use of Botox injection during TMJ and Migraine pain. The study was carried out in MNUMS, School Of Dentistry, PDIC hospital amongst patients with TMJ pain which splint therapy failed to show successful results and in patients with migraine pain. All patients received BOTULAX 200 units (Botulinum Toxin Type A) 20U per 0.1 ml , injected with 1ml syringe and 31G size pin to TMJ and migraine reliantpoints , 10-50U per each spot total of 200U. 15 patients with TMJ , 15 patients with migraine pain received BOTULAX 200 units (Botulinum Toxin Type A) and tested the results after 1 month, 3 months , 6 months, and 1 year periods. The TMJ pain has completely numbed after 1 to 12 months. In patients with migraine dependent pain after 1 month of supervision the suffering has eased down but the patient’s definition of pain was on 3-4 point. After 3 months of surveillance, 15 patients with migraine dependent pain had been relieved of the pain and had not been diagnosed for the following 12 months. The result of our study shows that the Botox injection is effective during TMJ and Migraine dependent pain.

Effect of Early Incision Combined with A Botox on the Recovery of Incision in the Small Area of Facial Scar / 医学研究杂志

Objective To investigate the effect of early incision of botulinum toxin type A (A Botox) on the recovery of the incision in the small area of the opposite side of the incision.Methods Totally 300 cases of facial small area scar surgery were randomly divided into three groups according to the random number table,with 100 cases in each group.The pations of normal group according to the conventional method,the facial scar surgery,after the surgery,clean cut,did not do special treatment.The pations of control group were treated according to the conventional method for facial scar surgery,postoperative cleaning of incision,from postoperative to postoperative 3 months reduction treatment,were treated with 3M free seam tape.The pations of observation group in the same way for facial scar surgery,a local injection of Botox and from postoperative to postoperative 3 months reduction treatnent,were treated with 3M free seam tape.After 3 months and 1 years of follow-up,the condition of scar recovery were evaluated.After 1 years of follow-up,the treatment efficiency was compared.Results Treatment for 3 months,the VSS,OSAS,and PSAS of observation group were 5.2 ± 1.4,14.7 ± 2.4,15.4 ±3.6,were lower than those of the control group and those of the normal group (P ＜ 0.05).One year after treatment,the score of VSS,OSAS,and PSAS of three groups were reduced.Those of observation group were lower than those in the control group and those in the normal group (P ＜ 0.05).The cure rate of observation group was 82％,which was significantly higher than that of the control group 63％and that of the normal group 52％ (P ＜ 0.05).The total effective rate of observation group was 97％,was significantly higher than that of the control group 85％ and that of the normal group 79％ (P ＜ 0.05).Conclusion The method of BotoxA early incision injection combined with the reduction method can effectively promote the small area of facial scar surgery incision recovery effect,improve the cure rate,to meet the needs of patients with facial beauty.

Synthesis and Anti-wrinkle Efficacy of Botox-like Polypeptide / 医药导报

Objective To develop a new botox-like polypeptide with anti-wrinkle and anti-aging functions, which will be used in the field of cosmetics and dermatology. Methods A series of new peptide compounds were synthesized via modifying the structure of SYN-AKE by peptide synthesis technology. Simulating muscle contraction by using co-culture model of human muscle cells and mouse embryonic spinal cord neurons to test the effects. Results Six new synthetic peptides were selected. The results showed that the muscle contraction frequency was lowered by adding C19 H30 N5 O4 compound than adding SYN-AKE in 1 min(P<0.05). Conclusion C19H30N5O4 is expected to become a new cosmetic peptide raw material and dermatology drug in the field of anti-wrinkle and anti-aging.

Synthesis and Anti-wrinkle Efficacy of Botox-like Polypeptide / 医药导报

Objective To develop a new botox-like polypeptide with anti-wrinkle and anti-aging functions, which will be used in the field of cosmetics and dermatology. Methods A series of new peptide compounds were synthesized via modifying the structure of SYN-AKE by peptide synthesis technology. Simulating muscle contraction by using co-culture model of human muscle cells and mouse embryonic spinal cord neurons to test the effects. Results Six new synthetic peptides were selected. The results showed that the muscle contraction frequency was lowered by adding C19 H30 N5 O4 compound than adding SYN-AKE in 1 min(P<0.05). Conclusion C19H30N5O4 is expected to become a new cosmetic peptide raw material and dermatology drug in the field of anti-wrinkle and anti-aging.

Repeated injections of botulinum toxin into the masseter muscle induce bony changes in human adults: A longitudinal study / 대한치과교정학회지

OBJECTIVE: To evaluate soft- and hard-tissue changes in the mandibular angle area after the administration of botulinum toxin type A (BoNT-A) injection to patients with masseteric hypertrophy by using three-dimensional cone-beam computed tomography (3D-CBCT). METHODS: Twenty volunteers were randomly divided into two groups of 10 patients. Patients in group I received a single BoNT-A injection in both masseter muscles, while those in group II received two BoNT-A injections in each masseter muscle, with the second injection being administered 4 months after the first one. In both groups, 3D-CBCT was performed before the first injection and 6 months after the first injection. RESULTS: Masseter muscle thicknesses and cross-sectional areas were significantly reduced in both groups, but the reductions were significantly more substantial in group II than in group I. The intergonial width of the mandibular angle area did not change significantly in either group. However, the bone volume of the mandibular gonial angle area was more significantly reduced in group II than in group I. CONCLUSIONS: The repeated administration of BoNT-A injections may induce bone volume changes in the mandibular angle area.

Diffuseness comparison of two kinds of botulinum toxins type A on the forehead / 中华医学美学美容杂志

Objective To evaluate the diffuse characteristics of two types of botulinum toxin type A (BOTOX and CBTX A) in the forehead and the effect of intradermal (ID) and subcutanous (SC) infections on their diffusion.Methods Healthy volunteers (n =20) were recruited to receive a 0.05 ml (2 U) injection of botulinum toxin type A at four forehead sites [both sides of medial forehead (SC) and temporal forehead (ID)],one side for BOTOX and another for CBTX-A.On day 14,the Minors' iodine starch test was performed and photographs were taken for calculating the area and dimensions of anhydrotic area.Results The areas of anhidrosis ID were significantly greater with CBTX-A (180±15) mm2 than that of BOTOX (144±14) mm2.The same conditions occurred in vertical dimensions (14.4±1.1) mm vs.(15.8±1.0) mm and horizontal dimensions (10.8±0.6) mm vs.(12.5±0.7) mm.There was significant variation between the both for diffuseness in the two anhidrotic halos observed after ID injection (P＜0.05).The areas of anhidrosis by SC were significantly greater with CBTX-A (207±17) mm2 than that in BOTOX (183±18) mm2.The mean horizontal dimension was greater with CBTX-A by SC (13.2±0.6) mm than that of BOTOX by SC (12.2±0.7) mm,but not statistically significant (P =0.06).The mean horizontal dimension in BOTOX was significantly greater with SC than that with ID (P＜0.05).There was no statistically significant difference between SC and ID administration of CBTX-A.Conclusions BOTOX diffuses less than CBTX-A.ID injection technique may result in less diffusion than SC.

Corrección de la sonrisa con toxina botulínica en un paciente con parálisis facial / Smile enhancement with botulinum toxin in a patient with facial palsy

Resumen: La parálisis facial altera la función muscular desencadenando diversas alteraciones funcionales, psicológicas, emocionales, estéticas y sociales. Existen múltiples causas y tratamientos quirúrgicos y no quirúrgicos para tratar el lado paralizado. Sin embargo, en pacientes con parálisis facial de larga evolución, en quienes el tratamiento quirúrgico ha generado mínimos beneficios o pacientes no candidatos a tratamientos quirúrgicos, el uso de toxina botulínica es una alternativa viable para tratar lado afectado cuando existen secuelas como sincinesias, hipertonía o espasmo hemifacial. En el lado no afectado también se utiliza para ocasionar simetría estética y funcional estática y dinámica. Se presenta un caso clínico de un paciente varón con parálisis facial idiopática derecha tratado con quimiodenervación contralateral selectiva con toxina botulínica y su evolución favorable hacia la funcionalidad y normalización de la simetría facial dinámica.

Abstract: By altering muscle function, facial palsy causes functional, psychological, emotional, aesthetic and social changes. There are several etiologies and multiple treatments to treat paralyzed side. However, patients with longstanding facial palsy, patients in whom surgical treatment has generated minimal benefits or patients who are not candidates for surgical treatments, the use of botulinum toxin is an adequate alternative to treat affected side when there are sequelae as sinkynesis, hypertony or hemifacial spasm. In the unaffected side is also used to cause static and dynamic aesthetic and functional symmetry. We present a male patient with right idiopathic facial palsy treated with selective contralateral chemodenervation with botulinum toxin. This treatment resulted in the patient's favorable evolution towards functionality and normalization of dynamic facial symmetry.

Evidencia y uso actual de toxina botulínica en patología otorrinolaringológica / Evidence and actual use of botulinum toxin in otolaryngology

A partir de los primeros usos terapéuticos de la toxina botulínica su utilización se ha extendido a variadas ramas de la medicina incluyendo la otorrinolaringología. Se considera un medicamento seguro en manos de profesionales capacitados y su utilización se realiza a través de un procedimiento mínimamente invasivo con efectos adversos leves y transitorios. Se usa en un amplio número de patologías otorrinolaringológicas y de cabeza y cuello. Actualmente la toxina botulínica A representa la primera línea de tratamiento en pacientes con disfonía espasmódica y distonía cervical. Existe evidencia de buen nivel que recomienda su uso para el manejo de sialorrea, temblor laríngeo, trastornos de la ATM, bruxismo y rinitis en casos seleccionados. Presenta buenos resultados en otras patologías como espasmo faringoesofágico, síndrome de Frey y tinnitus, sin embargo, todavía son necesarios más estudios.

Since the first therapeutic uses of botulinum toxin its role has extended to a wide range of medicine áreas including otolaryngology. It is considered a safe medication in the hands of trained professionals and its application represents a minimally invasive procedure with mild and transient adverse effects. It has been used in a wide range of otolaryngology and head and neck pathologies. Today botulinum toxin a represents the first choice of treatment for patients with spasmodic dysphonia and cervical dystonia. There is good evidence that supports its use for shialorrea, laryngeal tremor, temporomandibular joint disorders, bruxism and selected cases of rhinitis. For pharyngo-oesophageal spasm, Frey's syndrome and tinnitus there have been studies that show a beneficial effect however more studies are required for routine recommendation.

Comparative Study of Hugel-tox(R) versus Botox(R) for the Treatment of Essential Blepharospasm

PURPOSE: To compare clinical efficacy and duration of Hugel-tox(R) (also known as Botulax(R)) and Botox(R) for the treatment of essential blepharospasm. METHODS: A total of 48 patients who were injected with Hugel-tox(R) (17 females, 7 males) or Botox(R) (18 females, 6 males) from February 2013 to October 2013 were enrolled in the present study. Changes in eyelid closing force and Scott grade before and after injection were analyzed. Adverse events were also evaluated. RESULTS: There were no significant differences between the Hugel-tox(R) and Botox(R) groups in clinical efficacy and duration. Before and after injection, changes in Scott grade (Hugel-tox(R): -1.17 +/- 0.70, Botox(R): -1.21 +/- 0.72, p = 0.840), changes in eyelid closing force (Hugel-tox(R): -1.38 +/- 0.58, Botox(R): -1.17 +/- 0.56, p = 0.212) and duration (Hugel-tox(R): 116.08 +/- 22.12 days, Botox(R): 126.92 +/- 38.94 days, p = 0.242) were shown. No serious adverse events were found in either group. CONCLUSIONS: Hugel-tox(R) showed nearly equal efficacy and duration compared with Botox(R).

The use of botulinum toxin type A in the treatment of HTLV-1-associated overactive bladder refractory to conventional therapy

Urinary symptoms occur in 19% of human T-cell lymphotropic virus type 1 (HTLV-1)-infected patients who do not fulfill criteria for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and in almost 100% of HAM/TSP patients. Few studies have evaluated therapies for overactive bladder (OAB) caused by HTLV-1 infection. This case report describes the effect of onabotulinum toxin A on the urinary manifestations of three patients with HAM/TSP and OAB symptoms. The patients were intravesically administered 200 units of Botox®. Their incontinence episodes improved, and their OAB symptoms scores (OABSS) reduced significantly. These data indicate that Botox® should be a treatment option for OAB associated with HTLV-1 infection.

Effect of the Refrigerator Storage Time on the Potency of Botox for Human Extensor Digitorum Brevis Muscle Paralysis

BACKGROUND AND PURPOSE: It is recommended that Botox be used within 5 hours of reconstitution, which results in substantial quantities being discarded. This is not only uneconomic, but also inconvenient for treating patients. The aim of this study was to determine the potencies of Botox used within 2 hours of reconstitution with unpreserved saline, the same Botox refrigerated (at +4degrees C) 72 hours after reconstitution, and during the next 4 consecutive weeks (weeks 1, 2, 3, and 4). This comparison was used to determine the length of refrigeration time during which reconstituted Botox will maintain the same efficacy as freshly reconstituted toxin. METHODS: Individual paralysis rates in the extensor digitorum brevis (EDB) compound muscle action potential (CMAP) amplitude and area were measured 1 week after injecting fresh reconstituted 2.5 MU of Botox on one side of the foot, and when the same quantity of Botox that had been refrigerated for a designated time (i.e., 72 h, or 1, 2, 3, or 4 weeks) into the other side of the foot. The EDB CMAP amplitude and area at 12 and 16 weeks postinjection were also measured to compare the efficacy durations in all five comparative groups. RESULTS: Ninety-four volunteers were divided into five groups according to the refrigerator storage time of the second Botox injection. The paralysis of the EDBs was significant for each injection of Botox, both fresh and refrigerated, with no statistically significant differences between them, regardless of the refrigeration time. There was a tendency toward increased CMAP amplitude and area at 12 or 16 weeks postinjection (p<0.0001). The duration of effective muscle paralysis did not differ significantly throughout the 16-week follow-up period between all five groups. CONCLUSIONS: The potency of reconstituted Botox is not degraded by subsequent refrigeration for 4 weeks. However, there are definite concerns regarding its sterility, and hence its safety, since multiple withdrawals from the same vial over long periods can introduce bacterial contamination.

Electromyogram-guided Botox Treatment for Focal Dystonia in a Pianist's Hand / 대한정형외과학회잡지

Focal dystonia of musicians is one of the most disabling problems for professional musicians. It has focal task-specificity, presenting with involuntary flexion or extension of individual fingers when musicians play their instruments. It occurs mostly in pianists, and controversies still exist about the pathophysiology, whether it is caused by motor function disability or by a psychological condition. Although sensorimotor rehabilitation, change in instrument, skill or teacher, and immobilization with brace have been tried as treatment, there is still no definitive treatment. Because botox therapy has been effective in certain cases without irreversible side effects, this could be applied even in professional players. We report a case of focal dystonia of the hand in a professional pianist treated using electromyogram-guided botox injection and a review of the relevant medical literature.

Pseudoaneurysm of the Facial Artery after the Injection of Botox

Facial artery pseudoaneurysm is a rare lesion that can be mistaken for an epidermal cyst or other lesions. We present here the case of an iatrogenic pseudoaneurysm of the facial artery branch that was caused by Botox injection. Botox is frequently used for cosmetic and therapeutic purposes in any part of the body. We treated this lesion by performing aneurysmectomy, and the histopathologic analysis showed myxoid degeneration.