Title:Efficacy and Safety Analysis of Botox Application and Iatrogenic Botulism:
Panacea or Peril?
Volume: 30
Issue: 8
Author(s): Ozgur Karcioglu*, Canan Akman and Ilknur Atnis
Affiliation:
- Department of Emergency Medicine, Taksim Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
Keywords:
Clostridium botulinum, botulinum toxin, Botox, botulism, iatrogenic botulism, paresis, respiratory paralysis.
Abstract: Clostridium botulinum toxin-A (BoNT-A) creates temporary paralysis in the muscles by acting on
the muscle-nerve junction. It is injected into the mimic muscles when a decrease in the movements of the mimic
muscles is desired. Despite many favorable applications, the use of BoNT-A is not without drawbacks. Although
there is no expected serious side effect on health in BoNT-A treatments, various problems can be encountered
in patients treated for aesthetic purposes. Botulism is a rare but potentially life-threatening syndrome,
which is caused by the toxin produced by the bacterium Clostridium botulinum, which acts on the nervous
system, vegetative forms of C. botulinum can only survive in anaerobic conditions, while spore forms are
common in nature and can withstand harsh conditions. Botulism can stem from bacterial spores which release
toxin in the body; in the form of enteric botulism, and wound botulism. The cases that develop ‘iatrogenic botulism’
after such procedures are usually those receiving high-dose toxin for therapeutic purposes. The treatment
of botulism mainly consists of anti-toxin therapy and, if necessary, intensive care to prevent organ failures,
including respiratory support. This article aims to cover all these issues related to botulism and other adverse
outcomes related to BoNT-A injection in light of the most recent literature.