Korean J Med.  2013 Jun;84(6):851-854.

A Case of Dyspnea Caused by Local Botulinum Toxin Type A Injection

Affiliations
  • 1Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr
  • 2Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Botulinum toxin type A is widely used for functional improvement of muscles and aesthetic plastic surgery. It paralyzes the injected muscle by inhibiting acetylcholine release from synapses of neuromuscular junctions. We herein report a case of progressive respiratory distress after botulinum toxin injection at both the gastrocnemius and soleus muscles. The patient also showed ptosis, dysphonia, dysphagia, and general weakness. Vocal cord dysfunction was observed by laryngoscopy. Other neurologic examination findings, including those of the physical examination, brain MRI, and Jolly's test, were normal. To our knowledge, this is the first report of botulinum toxin injection associated with dyspnea (MRC dyspnea scale, grade 3) in Korea.

Keyword

Botulinum toxin; Type A; Dyspnea

MeSH Terms

Acetylcholine
Botulinum Toxins
Botulinum Toxins, Type A
Brain
Deglutition Disorders
Dysphonia
Dyspnea
Humans
Korea
Laryngoscopy
Muscles
Neurologic Examination
Neuromuscular Junction
Physical Examination
Surgery, Plastic
Synapses
Vocal Cords
Acetylcholine
Botulinum Toxins
Botulinum Toxins, Type A
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