RT Journal Article SR Electronic T1 Generalised muscular weakness after botulinum toxin injections for dystonia: a report of three cases JF Journal of Neurology, Neurosurgery & Psychiatry JO J Neurol Neurosurg Psychiatry FD BMJ Publishing Group Ltd SP 90 OP 93 DO 10.1136/jnnp.67.1.90 VO 67 IS 1 A1 K P Bhatia A1 A Münchau A1 P D Thompson A1 M Houser A1 V S Chauhan A1 M Hutchinson A1 A H V Shapira A1 C D Marsden YR 1999 UL http://jnnp.bmj.com/content/67/1/90.abstract AB Three patients are reported on who developed transient generalised weakness after receiving therapeutic doses of botulinum toxin for cervical dystonia (one case) and symptomatic hemidystonia (two cases) respectively. Clinical and electrophysiological findings were in keeping with mild botulism. All patients had received previous botulinum toxin injections without side effects and one patient continued injections without recurrence of generalised weakness. The cause is most likely presynaptic inhibition due to systemic spread of the toxin. Patients with symptomatic dystonia may be more likely to have this side effect and botulinum toxin injections in these patients should be carried out cautiously.