Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity
Botulinum toxin type A has been approved for spasticity management in poststroke patients. The adverse effects are generally of two types: those related to local injection; and those related to the systemic effects from spread of the toxin. Contralateral weakness after botulinum toxin A treatment i...
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Format: | Article |
Language: | English |
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Ordem dos Médicos
2020-11-01
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Series: | Acta Médica Portuguesa |
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Online Access: | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11503 |
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author | Alexandre Camões- Barbosa Inês Mendes Ribeiro Luisa Medeiros |
author_facet | Alexandre Camões- Barbosa Inês Mendes Ribeiro Luisa Medeiros |
author_sort | Alexandre Camões- Barbosa |
collection | DOAJ |
description |
Botulinum toxin type A has been approved for spasticity management in poststroke patients. The adverse effects are generally of two types: those related to local injection; and those related to the systemic effects from spread of the toxin. Contralateral weakness after botulinum toxin A treatment is a rarely reported adverse effect. We report the case of a 33-year-old female who had been receiving regular injections of incobotulinum toxin A due to spasticity of the right limbs after a hemorrhagic stroke. A switch was made to abobotulinum toxin A with an overall conversion ratio of 1:3.83. The patient presented contralateral upper limb paresis, especially of the deltoid muscle, in the second week post-injection. The electroneuromyography showed neuromuscular block due to botulinum toxin A. She recovered completely after eight months. A switch between different formulations of botulinum toxin type A should prompt caution when carrying out unit conversions. Distant side effects may appear, including paresis in the contralateral limbs.
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first_indexed | 2024-04-11T19:08:30Z |
format | Article |
id | doaj.art-8d90ec46efa94826b45905dc7f1a5dea |
institution | Directory Open Access Journal |
issn | 0870-399X 1646-0758 |
language | English |
last_indexed | 2024-04-11T19:08:30Z |
publishDate | 2020-11-01 |
publisher | Ordem dos Médicos |
record_format | Article |
series | Acta Médica Portuguesa |
spelling | doaj.art-8d90ec46efa94826b45905dc7f1a5dea2022-12-22T04:07:40ZengOrdem dos MédicosActa Médica Portuguesa0870-399X1646-07582020-11-01331110.20344/amp.115034963Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke SpasticityAlexandre Camões- Barbosa0Inês Mendes Ribeiro1Luisa Medeiros2Neurotoxin Clinic. Neurophysiology Unit. Centro Hospitalar Universitário de Lisboa Central. Lisboa.Physical Medicine and Rehabilitation Department. Hospital Prof. Doutor Fernando Fonseca. Amadora.Neurophysiology Unit. Centro Hospitalar de Lisboa Central. Lisboa. Botulinum toxin type A has been approved for spasticity management in poststroke patients. The adverse effects are generally of two types: those related to local injection; and those related to the systemic effects from spread of the toxin. Contralateral weakness after botulinum toxin A treatment is a rarely reported adverse effect. We report the case of a 33-year-old female who had been receiving regular injections of incobotulinum toxin A due to spasticity of the right limbs after a hemorrhagic stroke. A switch was made to abobotulinum toxin A with an overall conversion ratio of 1:3.83. The patient presented contralateral upper limb paresis, especially of the deltoid muscle, in the second week post-injection. The electroneuromyography showed neuromuscular block due to botulinum toxin A. She recovered completely after eight months. A switch between different formulations of botulinum toxin type A should prompt caution when carrying out unit conversions. Distant side effects may appear, including paresis in the contralateral limbs. https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11503Botulinum ToxinsType A/adverse effectsMuscle Weakness/etiologyUpper Extremity |
spellingShingle | Alexandre Camões- Barbosa Inês Mendes Ribeiro Luisa Medeiros Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity Acta Médica Portuguesa Botulinum Toxins Type A/adverse effects Muscle Weakness/etiology Upper Extremity |
title | Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity |
title_full | Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity |
title_fullStr | Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity |
title_full_unstemmed | Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity |
title_short | Contralateral Upper Limb Weakness Following Botulinum Toxin A Injection for Poststroke Spasticity |
title_sort | contralateral upper limb weakness following botulinum toxin a injection for poststroke spasticity |
topic | Botulinum Toxins Type A/adverse effects Muscle Weakness/etiology Upper Extremity |
url | https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11503 |
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