Table Summary of clinical and electrophysiological features of reported patients with generalised weakness after BT injections
| Age/ sex | Injections for (primary diagnosis) | Prior years of injections | Muscles injected /total dose | Distribution of weakness | Onset /duration | Electrophysiology | FU | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Our patients: | ||||||||||||
| 45/F | Cervical dystonia | 5 | scm, splenii, | Generalised UL>LL dysphagia | 1 week | Fibrillations, small and short MUP | Recovered, no further injections | |||||
| /650 U/Dys | /6 months | abnormal jitter, and blockings | ||||||||||
| Mild decrement | ||||||||||||
| 57/F | Arm dystonia (symptomatic hemidystonia) | 2.5 | L arm /900 U/Dys | Generalised UL>LL | 2 weeks /3 months | Abnormal jitter and blocking Mild decrement | Recovered, no problems with further injections | |||||
| 32/F | Leg dystonia (symptomatic hemidystonia) | 2.5 | L foot /600/Dys | Generalised UL>LL dysphagia | 1 week /3 months | EMG normal SFEMG normal | Similar episode on repeat injections. None since | |||||
| Reported cases (Bakheit et al 8) | ||||||||||||
| 67/F | Spasticity (MS) | nil | L leg | Generalised LL>UL dysphagia ptosis | 4 days | EMG “denervation” | Recovered | |||||
| 1×injection | /250 U/Dys | /4 weeks | Abnormal jitter and blocking | |||||||||
| 34/F | Torticollis (MSA) | 5 | scm, splenius | Generalised proximal dysphagia | 3 weeks | EMG “denervation” | Recovered | |||||
| /250 U/Dys | /4 months | Abnormal jitter and blocking | ||||||||||
Scm=sternocleidomastoid muscle; LL=lower limb; UL=upper limbs; Dys=Dysport, RNS=repetitive nerve stimulation; SFEMG=single fibre EMG; MUP=motor unit potentials; MSA=muscle system atrophy; MS=multiple sclerosis.