2015
DOI: 10.1017/cjn.2015.314
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Adverse Clinical Effects of Botulinum Toxin Intramuscular Injections for Spasticity

Abstract: Objective: The adverse events (AEs) with botulinum toxin type-A (BoNTA), used for indications other than spasticity, are widely reported in the literature. However, the site, dose, and frequency of injections are different for spasticity when compared to the treatment for other conditions and hence the AEs may be different as well. The objective of this study was to summarize the AEs reported in Canada and systematically review the AEs with intramuscular botulinum toxin injections to treat focal spasticity. Me… Show more

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Cited by 28 publications
(51 citation statements)
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References 69 publications
(250 reference statements)
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“…The injections were safe and well tolerated, and without clinically significant adverse effects. Most importantly, the treatment did not produce weakness, which is a common adverse effect with current treatment options for spasticity (Phadke et al, 2015). Side effects of muscle weakness and fatigue are major impediments to recovery in patients with neurologic injury.…”
Section: Discussionmentioning
confidence: 98%
See 1 more Smart Citation
“…The injections were safe and well tolerated, and without clinically significant adverse effects. Most importantly, the treatment did not produce weakness, which is a common adverse effect with current treatment options for spasticity (Phadke et al, 2015). Side effects of muscle weakness and fatigue are major impediments to recovery in patients with neurologic injury.…”
Section: Discussionmentioning
confidence: 98%
“…Current treatment options for spasticity include oral medications such as benzodiazepines, baclofen, and tizanidine that are central nervous system depressants used to suppress spinal hyper-excitability, and local injections of botulinum toxin used to suppress muscle overactivity. Whereas the oral medications can produce cognitive deficits, fatigue, and muscle weakness, botulinum toxin injections produce focal muscle weakness (Phadke et al, 2015). It is thus necessary to carefully balance the risks and benefits of treatment, which often remains inadequate.…”
Section: Introductionmentioning
confidence: 99%
“…Adverse clinical effects following intramuscular injection of BoNT are well established, with some patients reporting muscle weakness, oropharyngeal/ respiratory alterations, bowel and bladder disturbances and infections, some of which require higher levels of care (31). Instrumented guidance of BoNT injection, such as electrical stimulation or ultrasonography, is strongly recommended (32,33).…”
Section: Local Effectsmentioning
confidence: 99%
“…OnabotA is administered locally and the clinical effects are expected to be limited to structures in the vicinity of the injection region. However, respiratory-related adverse events and respiratory dysfunction have been reported in some patients following injection into the limbs for the treatment of spasticity, although these are not always considered treatment related [ 4 , 5 , 6 ]. These changes may be due to systemic spread of toxin at high doses or from worsening neurologic status from spasticity, cognition, or other unrelated medical illness.…”
Section: Introductionmentioning
confidence: 99%