Botulinum toxin A poisoning by local aesthetic injection: clinical and electrophysiological analyses of 20 cases / 中华医学美学美容杂志

ABSTRACT

Objective@#To observe the clinical and electrophysiological characteristics of botulinum toxin A poisoning induced by local cosmetic injection, and to explore the possible pathogenesis.@*Methods@#Clinical data of 20 patients with botulinum toxin type A local cosmetic injection poisoning admitted to our hospital from January 2016 to December 2018 were collected and electrophysiological tests were carried out.@*Results@#The clinical manifestations of 20 patients were mainly 15/20 (75.0%) with limb weakness, and the proximal end was heavier than the distal 20/20 (100%), and the upper limb was heavier than the lower limb 26/20 (80%), followed by dysphagia 12/20 (60%), dysarthria 5/20 (25%), cervical muscle weakness 5/20 (25%), extraocular muscle paralysis 4/20 (20%), masseter muscle weakness 3/20 (15%) and respiratory muscle weakness 2/20 (5.0%) with respiratory failure 1/20 (5.0%). The results of neurophysiological examination showed the highest rate of SFEMG (90.0%), followed by RNS (80.0%), EMG (65.0%) and NCV (40.0%), suggesting that neuromuscular junction dysfunction was the main presentation. Patients who actively gave botulinum antitoxin injection therapy and symptomatic support treatment had good prognosis.@*Conclusions@#Local cosmetic injection of botulinum toxin type A may lead to poisoning. The symptoms of poisoning are mainly caused by limb weakness. Neuroelectrophysiological examination can assist in the diagnosis of botulinum toxin poisoning.