Botulinum neurotoxin A: an unusual systemic effect. 2007

Katherine Howell, and Paulo Selber, and H Kerr Graham, and Dinah Reddihough
Department of Child Development and Rehabilitation, Royal Children's Hospital, Parkville, Victoria, Australia.

Systemic effects from Botulinum neurotoxin A are uncommon but can have serious consequences. We report the case of a boy with severe cerebral palsy who developed deterioration in respiratory and oromotor function following repeated injections of Botulinum neurotoxin A. Caution is needed in using this treatment in children with severe cerebral palsy and pseudobulbar palsy.

UI MeSH Term Description Entries
D008297 Male Males
D009465 Neuromuscular Agents Drugs used for their actions on skeletal muscle. Included are agents that act directly on skeletal muscle, those that alter neuromuscular transmission (NEUROMUSCULAR BLOCKING AGENTS), and drugs that act centrally as skeletal muscle relaxants (MUSCLE RELAXANTS, CENTRAL). Drugs used in the treatment of movement disorders are ANTI-DYSKINESIA AGENTS. Skeletal Muscle Relaxants,Neuromuscular Effect,Neuromuscular Effects,Agents, Neuromuscular,Effect, Neuromuscular,Effects, Neuromuscular,Muscle Relaxants, Skeletal,Relaxants, Skeletal Muscle
D012135 Respiratory Sounds Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT. Breathing Sounds,Crackles,Lung Sounds,Pleural Rub,Rales,Rhonchi,Stridor,Wheezing,Breathing Sound,Crackle,Lung Sound,Pleural Rubs,Rale,Respiratory Sound,Rhonchus,Rub, Pleural,Sound, Breathing,Sound, Lung,Sound, Respiratory,Sounds, Breathing,Sounds, Lung,Stridors,Wheezings
D002547 Cerebral Palsy A heterogeneous group of nonprogressive motor disorders caused by chronic brain injuries that originate in the prenatal period, perinatal period, or first few years of life. The four major subtypes are spastic, athetoid, ataxic, and mixed cerebral palsy, with spastic forms being the most common. The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. Spastic diplegia (Little disease) is the most common subtype, and is characterized by spasticity that is more prominent in the legs than in the arms. Pathologically, this condition may be associated with LEUKOMALACIA, PERIVENTRICULAR. (From Dev Med Child Neurol 1998 Aug;40(8):520-7) Diplegic Infantile Cerebral Palsy,Little Disease,Monoplegic Cerebral Palsy,Quadriplegic Infantile Cerebral Palsy,Spastic Diplegia,CP (Cerebral Palsy),Cerebral Palsy, Athetoid,Cerebral Palsy, Atonic,Cerebral Palsy, Congenital,Cerebral Palsy, Diplegic, Infantile,Cerebral Palsy, Dyskinetic,Cerebral Palsy, Dystonic-Rigid,Cerebral Palsy, Hypotonic,Cerebral Palsy, Mixed,Cerebral Palsy, Monoplegic, Infantile,Cerebral Palsy, Quadriplegic, Infantile,Cerebral Palsy, Rolandic Type,Cerebral Palsy, Spastic,Congenital Cerebral Palsy,Diplegia, Spastic,Infantile Cerebral Palsy, Diplegic,Infantile Cerebral Palsy, Monoplegic,Infantile Cerebral Palsy, Quadriplegic,Little's Disease,Monoplegic Infantile Cerebral Palsy,Rolandic Type Cerebral Palsy,Athetoid Cerebral Palsy,Atonic Cerebral Palsy,Cerebral Palsies, Athetoid,Cerebral Palsies, Dyskinetic,Cerebral Palsies, Dystonic-Rigid,Cerebral Palsies, Monoplegic,Cerebral Palsy, Dystonic Rigid,Cerebral Palsy, Monoplegic,Diplegias, Spastic,Dyskinetic Cerebral Palsy,Dystonic-Rigid Cerebral Palsies,Dystonic-Rigid Cerebral Palsy,Hypotonic Cerebral Palsies,Hypotonic Cerebral Palsy,Mixed Cerebral Palsies,Mixed Cerebral Palsy,Monoplegic Cerebral Palsies,Spastic Cerebral Palsies,Spastic Cerebral Palsy,Spastic Diplegias
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003680 Deglutition Disorders Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS. Dysphagia,Swallowing Disorders,Esophageal Dysphagia,Oropharyngeal Dysphagia,Deglutition Disorder,Disorders, Deglutition,Dysphagia, Esophageal,Dysphagia, Oropharyngeal,Swallowing Disorder
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D019274 Botulinum Toxins, Type A A serotype of botulinum toxins that has specificity for cleavage of SYNAPTOSOMAL-ASSOCIATED PROTEIN 25. Botulinum Neurotoxin Type A,Botulinum Toxin A,Botulinum Toxin Type A,Botox,Botulinum A Toxin,Botulinum Neurotoxin A,Clostridium Botulinum Toxin Type A,Clostridium botulinum A Toxin,Meditoxin,Neuronox,Oculinum,Onabotulinumtoxin A,OnabotulinumtoxinA,Vistabel,Vistabex,Neurotoxin A, Botulinum,Toxin A, Botulinum,Toxin, Botulinum A
D020828 Pseudobulbar Palsy A syndrome characterized by DYSARTHRIA, dysphagia, dysphonia, impairment of voluntary movements of tongue and facial muscles, and emotional lability. This condition is caused by diseases that affect the motor fibers that travel from the cerebral cortex to the lower BRAIN STEM (i.e., corticobulbar tracts); including MULTIPLE SCLEROSIS; MOTOR NEURON DISEASE; and CEREBROVASCULAR DISORDERS. (From Adams et al., Principles of Neurology, 6th ed, p489) Dysarthria, Pseudobulbar,Paralysis, Pseudobulbar,Spastic Bulbar Palsy,Pseudobulbar Mutism,Pseudobulbar Paralysis,Pseudobulbar Paresis,Pseudobulbar Syndrome,Bulbar Palsies, Spastic,Bulbar Palsy, Spastic,Dysarthrias, Pseudobulbar,Mutism, Pseudobulbar,Mutisms, Pseudobulbar,Palsies, Pseudobulbar,Palsies, Spastic Bulbar,Palsy, Pseudobulbar,Palsy, Spastic Bulbar,Paralyses, Pseudobulbar,Pareses, Pseudobulbar,Paresis, Pseudobulbar,Pseudobulbar Dysarthria,Pseudobulbar Dysarthrias,Pseudobulbar Mutisms,Pseudobulbar Palsies,Pseudobulbar Paralyses,Pseudobulbar Pareses,Pseudobulbar Syndromes,Spastic Bulbar Palsies,Syndrome, Pseudobulbar,Syndromes, Pseudobulbar

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