Page 1 of 2 12 LastLast
Results 1 to 10 of 13

Thread: Systemic Reaction to Botox

  1. #1

    Systemic Reaction to Botox

    I am scheduled to have botox injections in my bladder, early of next year. My physiotherapist was also looking into injections for my legs too. I will do anything that works for both of these problems.

    However, I have a friend at lawschool who is also a para, same level and everything and she had a negative reaction to botox. We are having the exact same problem with our legs in terms of severe tone. Anyways, she experienced extreme muscle fatigue all over her body and she said at one point, she couldn't even transfer out of her chair. Yikes. They couldn't figure out what was going on but later determined that it was due to the botox.

    My question is, what is the likelihood that I will experience some type of reaction to the botox? Are there statistics for this? Are some people more susceptible to reactions than others?

  2. #2
    Quote Originally Posted by KiranA View Post
    I am scheduled to have botox injections in my bladder, early of next year. My physiotherapist was also looking into injections for my legs too. I will do anything that works for both of these problems.

    However, I have a friend at lawschool who is also a para, same level and everything and she had a negative reaction to botox. We are having the exact same problem with our legs in terms of severe tone. Anyways, she experienced extreme muscle fatigue all over her body and she said at one point, she couldn't even transfer out of her chair. Yikes. They couldn't figure out what was going on but later determined that it was due to the botox.

    My question is, what is the likelihood that I will experience some type of reaction to the botox? Are there statistics for this? Are some people more susceptible to reactions than others?
    There is no overall statistics, only some reports of complications in certain series. The incidence of side-effects, including generalized weakness is on the order of 3-8%, as the following recent abstracts suggest.
    1. Poo P, Galvan-Manso M, Casartelli MJ, Lopez-Casas J, Gassio-Subirats RM, Blanco C and Terricabras-Carol L (2008). [Botulinum toxin in infantile cerebral palsy]. Rev Neurol. 47 Suppl 1: S21-4. Servicio de Neuropediatria, Unidad Integrada Hospital Sant Joan de Deu-Clinic, E-08950 Esplugues de Llobregat, Barcelona. pilarpoo@hsjdbnc.org. INTRODUCTION: A number of studies have proved the effectiveness and safety of botulinum toxin in therapeutic doses. AIM: To analyse the results obtained over a 12-year period in which botulinum toxin type A (BTA) was used to treat infantile cerebral palsy (CP). PATIENTS AND METHODS: Of a total number of 547 patients who were treated, 515 had CP, 464 with spasticity, 46 with mixed CP and 5 with dyskinetic CP with focal dystonia. RESULTS: Overall evaluation of BTA is positive, both as regards its beneficial effects and its safety: tone was mildly improved in 18.5% of patients, with no change in motor functioning, 39% showed a moderate improvement, 19% a marked improvement and 5.6% experienced a marked and prolonged improvement. Forty-two patients (8.15%) presented side effects, the most common being weakness in the lower limbs, which occurred in 21 cases. CONCLUSIONS: BTA is a good therapeutic option for treating children with CP, not only for the focal involvement but also as palliative treatment in children with diffuse involvement.
    2. Bakheit AM (2006). The possible adverse effects of intramuscular botulinum toxin injections and their management. Curr Drug Saf. 1: 271-9. Peninsula Medical School, Universities of Exeter & Plymouth, Stroke Unit, Mount Gould Hospital, Plymouth, UK. magid.bakheit@pcs-tr.swest.nhs.uk. In the last two decades or so the intramuscular administration of botulinum toxin type A, and more recently type B, has become an established first line treatment of many neurological and other medical disorders. So far, the toxin has been used mainly by experienced researchers and clinicians with extensive knowledge of its mode of action and potential adverse effects. However, in the foreseeable future it is likely that this treatment will be provided by more medical practitioners and in different clinical settings, especially as the range of its clinical indications increases. Botulinum toxin, in therapeutic doses, is a remarkably safe drug with relatively few adverse effects. The commonest adverse effects are muscle weakness, fatigue, flu-like symptoms, a dry mouth, dizziness and a skin rash. Nonetheless, serious adverse events may occur, albeit rarely, and it is imperative that prescribers of this treatment are thoroughly familiar with its potential risks. The purpose of this article is to review the possible adverse effects of botulinum toxin intramuscular injections, to describe the factors that might predispose to them and to summarise the strategies for their prevention and treatment.
    3. Brin MF, Comella CL, Jankovic J, Lai F and Naumann M (2008). Long-term treatment with botulinum toxin type A in cervical dystonia has low immunogenicity by mouse protection assay. Mov Disord. 23: 1353-60. Allergan, Inc., Global Drug Development, Irvine, California, USA. To evaluate the immunogenicity of botulinum toxin type A (BoNTA; BOTOX) in cervical dystonia (CD). Subjects diagnosed with CD for > or =1 year and previously naive to BoNTs were treated with BoNTA in a prospective, open-label, multicenter study. Serum samples were analyzed for BoNTA neutralizing antibodies using the Mouse Protection Assay (MPA). Clinical resistance was assessed with a test injection of 20 U BoNTA placed unilaterally into the frontalis (Frontalis Antibody Test; FTAT) or corrugator muscle (Unilateral Brow Injection; UBI). Efficacy was assessed and adverse events were recorded. Of 326 subjects enrolled, 251 (77%) completed the study. Subjects received a median of 9 BoNTA treatments (mean dose per session ranged from 148.4 to 213.0 U over a mean of 2.5 years [range: 3.2 months-4.2 years]). Only 4 of 326 subjects (1.2%) tested positive for antibodies in the MPA; three of these subjects stopped responding clinically to BoNTA (of whom one also showed clinical resistance in the FTAT) and one continued to respond. Consistent improvements in the signs/symptoms of CD were noted. The most frequent treatment-related adverse events were mild to moderate weakness, dysphagia, neck pain, and injection-site pain. The current formulation of BoNTA rarely causes neutralizing antibody formation in CD subjects treated < or =4 years.
    4. Yaraskavitch M, Leonard T and Herzog W (2008). Botox produces functional weakness in non-injected muscles adjacent to the target muscle. J Biomech. 41: 897-902. Wilfrid Laurier University, Waterloo, Ont., Canada. Botulinum type-A (BTX-A) neurotoxin exerts a paralytic effect on muscles and is used increasingly to treat a variety of muscle spasticity disorders. While its pathogenesis for muscle-induced weakness has been well elucidated, the functional effects of BTX-A administration are incomplete. Specifically, weakness as a function of muscle length and stimulation frequency has only been investigated qualitatively in a few muscles and the possible effect of the toxin on non-target muscles, although considered possible based on laboratory experiments, has not been studied widely and the functional implications remain unknown. Therefore, the purpose of this study was to measure the functional implications of BTX-A on force production and possible weakness of a target muscle and a non-injected neighbouring muscle. The cat soleus was chosen as the target muscle and was injected with 3.2-3.5U of BTX-A/kg in one hind limb, while the soleus of the other hind limb served as a non-injected control. Force-length properties within and exceeding the functional range of motion were determined at frequencies of stimulation of 10, 30 and 50Hz. Force-length properties of the adjacent non-injected plantaris were also determined in the experimental and contralateral hind limb. Four weeks following BTX-A injections, peak soleus forces were decreased by 30% (50Hz), 29% (30Hz) and 29% (10Hz) and peak plantaris forces were decreased by 11% (50Hz), 16% (30Hz) and 16% (10Hz), in the experimental compared to the contralateral hind limb. Absolute BTX-associated force loss was significantly different at all frequencies of stimulation and all lengths for the soleus, while in the plantaris there was a significant force loss across long (> or = -4mm) but not short muscle lengths. Decreases in peak force were independent of the stimulation frequency. We concluded from the results of this study that BTX-A injection in the target muscle caused a measurable effect on force production and that force production was decreased in non-target neighbouring muscles at and near lengths of peak force production. These results are of particular importance in therapeutic procedures where isolated muscles are targeted for treatment. They should also be considered in neurophysiological studies in which BTX-A injections are used to selectively diminish muscle function.
    5. Hecht MJ, Stolze H, Auf dem Brinke M, Giess R, Treig T, Winterholler M and Wissel J (2008). Botulinum neurotoxin type A injections reduce spasticity in mild to moderate hereditary spastic paraplegia--report of 19 cases. Mov Disord. 23: 228-33. Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany. martin.hecht@bkh-kaufbeuren.de. Hereditary spastic paraplegia (HSP) is characterized by lower extremity spasticity. Symptomatic therapy generally includes physical therapy and oral antispastic agents, in selected cases intrathecal baclofen. Because of the positive results in other treatments of spasticity, the use of botulinum neurotoxin type A (BoNT-A) might also be considered for patients with HSP. We report the effect of BoNT-A injections in 19 unselected patients with HSP treated by the members of the German Spasticity Education Group. In 17 patients, the modified Ashworth scale had improved by one point. In one patient, it improved by three points. Most of the patients reported reduction of spasticity. BoNT-A injections were continued in 11 of 19 patients (57.9%). All of the patients with continued injections had a good or very good global subjective improvement. Patients with less pronounced spasticity and patients with accompanying physical therapy tended to exhibit a better effect. Only four patients reported adverse effects which were increased weakness in three patients and pain in one patient. BoNT-A injections appear to reduce spasticity effectively and safely, especially in patients with mild to moderate spasticity. The preliminary results of our case series should encourage larger studies of BoNT-A injections in HSP.
    6. Bjornson K, Hays R, Graubert C, Price R, Won F, McLaughlin JF and Cohen M (2007). Botulinum toxin for spasticity in children with cerebral palsy: a comprehensive evaluation. Pediatrics. 120: 49-58. Department of Rehabilitation Medicine, Children's Hospital and Regional Medical Center, MPW 8-3, 4800 Sand Point Way NE, Seattle, WA 98105, USA. kristie.bjornson@seattlechildrens.org. BACKGROUND: Spasticity is a prevalent disabling clinical symptom for children with cerebral palsy. Treatment of spasticity with botulinum toxin in children with cerebral palsy was first reported in 1993. Botulinum toxin provides a focal, controlled muscle weakness with reduction in spasticity. Interpretation of the literature is difficult because of the paucity of reliable measures of spasticity and challenges with measuring meaningful functional changes in children with disabilities. OBJECTIVE: This study documents the effects of botulinum toxin A injections into the gastrocnemius muscles in children with spastic diplegia. Outcomes are evaluated across all 5 domains of the National Centers for Medical and Rehabilitation Research domains of medical rehabilitation. METHODS: A randomized, double-masked, placebo-controlled design was applied to 33 children with spastic diplegia with a mean age of 5.5 and Gross Motor Function Classification System Levels of I through III. Participants received either 12 U/kg botulinum toxin A or placebo saline injections to bilateral gastrocnemius muscles. Outcomes were measured at baseline and 3, 8, 12, and 24 weeks after injection. RESULTS: Significant decreases in the electromyographic representation of spasticity were documented 3 weeks after botulinum toxin A treatment. A significant decrease in viscoelastic aspects of spasticity was present at 8 weeks, and subsequent increases in dorsiflexion range were documented at 12 weeks for the botulinum toxin A group. Improvement was found in performance goals at 12 weeks and in maximum voluntary torque and gross motor function at 24 weeks for the botulinum toxin A. There were no significant differences between groups in satisfaction with performance goals, energy expenditure, Ashworth scores, or frequency of adverse effects. CONCLUSIONS: The safety profile of 12 U/kg of botulinum toxin A is excellent. Although physiologic and mechanical effects of treatment with botulinum toxin A were documented with functional improvement at 6 months, family satisfaction with outcomes were no different. Communication is needed to ensure realistic expectations of treatment.
    7. Akbar M, Abel R, Seyler TM, Bedke J, Haferkamp A, Gerner HJ and Mohring K (2007). Repeated botulinum-A toxin injections in the treatment of myelodysplastic children and patients with spinal cord injuries with neurogenic bladder dysfunction. BJU Int. 100: 639-45. Department of Orthopaedic Surgery, University of Heidelberg, Heidelberg, Germany. Michael.Akbar@ok.uni-heidelberg.de. OBJECTIVES: To examine the effects of repeated detrusor injections of botulinum-A toxin (BTX) for possible changes in bladder function, muscular structure of the detrusor, increase in BTX tolerance (tachyphylaxis) and side-effects, as BTX is a new treatment alternative for patients with a neurogenic bladder condition that is difficult to treat and refractory to anticholinergic medication. PATIENTS AND METHODS: Between 2000 and 2005, 19 patients with myelodysplasia (MDP) and 25 spinal cord-injured (SCI) patients were treated with repeated suburothelial BTX injections (Dysport, Ipsen-Pharma, Ettlingen, Germany) or injections into the intramural detrusor. The follow-up was > or = 3 years (range 3-5, median 4.5). RESULTS: Detrusor compliance, bladder capacity, and detrusor pressure at maximum filling improved significantly (P < 0.001) compared to baseline after each BTX injection. There was prolonged efficacy of each BTX administration and all repeated injections in the paediatric and adult patients with neurogenic bladder dysfunction over a median follow-up of 4.5 years. There was no evidence for drug tolerance or changes in the morphological appearance of the bladder. Safety was good: no complications were associated with the injection procedure itself. Early in the treatment programme, three patients who received a dose of 1000 units Dysport showed systemic side-effects and generalized muscle weakness. These resolved without intervention and did not recur after reducing the adult dose to 750 units (paediatric dose 20 units/kg, not >400 units), which seems to be the optimum for good efficacy with an adequate safety margin. CONCLUSION: BTX injection is a safe and effective treatment for neurogenic detrusor hyperreflexia. Repeat treatments are as effective as the first: there was no indication of a lack of efficacy due to tachyphylaxis, antibody formation, or fibrosis of the detrusor muscle in this sample.
    8. Naumann M, Albanese A, Heinen F, Molenaers G and Relja M (2006). Safety and efficacy of botulinum toxin type A following long-term use. Eur J Neurol. 13 Suppl 4: 35-40. Department of Neurology, Academic Hospital Klinikum Augsburg, Augsburg, Germany. markus.naumann@neurologie.augsburg-med.de. Botulinum toxin serotype A (BoNT-A) has long heritage of use leading to confidence in its safety and efficacy. The application of BoNT-A does not lead to persistent histological changes in the nerve terminal or the target muscle. Clinical trials defined the safety and tolerability profile of BoNT-A across common therapeutic indications and showed an incidence of adverse events of approximately 25% in the BoNT-A-treated group compared with 15% in the control group. Focal weakness was the only adverse event to occur more often following BoNT-A treatment. Long-term BoNT-A administration has been assessed in various treatment settings, with the level and duration of BoNT-A efficacy response being maintained over repeated rounds of injection with no major safety concerns. The treatment of children with cerebral palsy often require long-term, repeated, multimuscle BoNT-A injections that lead to the administration of comparably higher toxin doses. Despite the high total body doses used, their distribution over multiple muscles and injection sites means that systemic side effects are rare. Recent formulation changes have reduced the incidence of antibody development following treatment with BOTOX. These findings show long-term BoNT-A treatment to be both safe and efficacious for a wide variety of indications.

  3. #3
    Senior Member stephen212's Avatar
    Join Date
    Jul 2001
    Location
    New York City
    Posts
    5,703
    Quote Originally Posted by KiranA View Post
    I am scheduled to have botox injections in my bladder, early of next year. My physiotherapist was also looking into injections for my legs too. I will do anything that works for both of these problems.

    However, I have a friend at lawschool who is also a para, same level and everything and she had a negative reaction to botox. We are having the exact same problem with our legs in terms of severe tone. Anyways, she experienced extreme muscle fatigue all over her body and she said at one point, she couldn't even transfer out of her chair. Yikes. They couldn't figure out what was going on but later determined that it was due to the botox.

    My question is, what is the likelihood that I will experience some type of reaction to the botox? Are there statistics for this? Are some people more susceptible to reactions than others?
    Kiran,

    I can appreciate your apprehension about getting bladder Botox injections. I had them as well though I'm happy to report that I have not had any adverse reaction to my first round of Botox -- and the results have been astounding! I'm not aware of any patient screening test that can distinguish between those that are more likely than others to experience side effects. The determining factor may be the experience of the urologist performing the procedure.

    I did, however, experience an episode of AD during the procedure, which consists of approximately 30 injections. The anesthesiologist had recommended that I get an epidural but that seemed pointless (to me, anyway) seeing as I'm a T4 complete so with the blessing of my uroligist, I declined. In all of my previous uro procedures prior to the Botox injections I never had any anesthetic, but this was different. If there's anything you should concern yourself with, I would suggest that your explore managing the possiblity of AD.

  4. #4
    Quote Originally Posted by stephen212 View Post
    Kiran,

    I can appreciate your apprehension about getting bladder Botox injections. I had them as well though I'm happy to report that I have not had any adverse reaction to my first round of Botox -- and the results have been astounding! I'm not aware of any patient screening test that can distinguish between those that are more likely than others to experience side effects. The determining factor may be the experience of the urologist performing the procedure.

    I did, however, experience an episode of AD during the procedure, which consists of approximately 30 injections. The anesthesiologist had recommended that I get an epidural but that seemed pointless (to me, anyway) seeing as I'm a T4 complete so with the blessing of my uroligist, I declined. In all of my previous uro procedures prior to the Botox injections I never had any anesthetic, but this was different. If there's anything you should concern yourself with, I would suggest that your explore managing the possiblity of AD.

    I had phenol injection on Oct7th and no regret.. simply awesome...cheap and 180 degree difference..i used on my left leg for the muscle that opens the leg and no doing catheter is WAY WAY WAY easier...

  5. #5
    I've been getting botox in my bladder for i think almost 3 years now (Wow!). I think its fabulous..no complaints what so ever!

    I'm a T4 and have no problems with AD while having it done. I'm in & out of the office within 30-45 minutes...simply a piece of cake!

    Another girl I know who is a quad pry like C6ish..she has had problems with AD and now needs to be put under in order to have it done.

    I don't experience AD really at all & she experiences it over the simplest thing..maybe thats the difference.
    Life is like a box of chocolates, you never know what you're gonna get.

  6. #6
    As far as I know, there is not a screening test to determine who isi going to suffer any of the side effects of botox. I would agree that it could possibly be related a little with the experience of the practitioner. It might also have to do with the amount of botox that is needed. I would also suggest that it might occur the more often you get the treatment.

    CKF

  7. #7
    Junior Member
    Join Date
    Apr 2009
    Location
    Wenatchee WA
    Posts
    1

    systemic reaction to botox

    I had great results with botox in Dec 2009, but it wore off, so I repeated June 2010. Effect was not as good for incontinence, so we did it again in 3mos instead of 6. Now I am experiencing weakness in my arms and also having more trouble transferring 3wks later. Nothing showing up to explain.
    If this is a systemic reaction to botox, how do you diagnose that and how long does it last?

  8. #8
    Hi Kiran,
    I've had botox 5 times already (first time 2003) and the effect on my bladder is fantastic. Second time they gave me di-sport (brand of botulinum toxine) and that time I experienced general weakness for a couple of months after. With botox (the brand), there's no side-effects for me.

  9. #9
    Senior Member marycsm77's Avatar
    Join Date
    Aug 2010
    Location
    Long Island, NY
    Posts
    2,298

    Botox injections into SCM muscle anyone?

    Has anyone had botox injected into SCM muscle. I have chronically inflamed SCM muscle since surgery, I can't stand it anymore. My pain management md is sending me to a neurologist who does this. I'm a little freaked out about the whole thing. Has anyone heard of Botox for this?

    thanks

  10. #10
    Senior Member stephen212's Avatar
    Join Date
    Jul 2001
    Location
    New York City
    Posts
    5,703
    Quote Originally Posted by marycsm77 View Post
    Has anyone had botox injected into SCM muscle. I have chronically inflamed SCM muscle since surgery, I can't stand it anymore. My pain management md is sending me to a neurologist who does this. I'm a little freaked out about the whole thing. Has anyone heard of Botox for this?

    thanks
    I've never heard of Botox being used to treat inflammatory conditions. If what you mean is that the SCM is in a chronic state of spasm, then perhaps Botox may be an appropriate tx. If not, then maybe a cortisone injection, which will alleviate inflammation.

Similar Threads

  1. Tendon Lengthening
    By Wise Young in forum Care
    Replies: 20
    Last Post: 09-07-2012, 08:15 AM
  2. Botox ads frowned on by regulator
    By Max in forum General News
    Replies: 0
    Last Post: 06-27-2003, 02:22 PM
  3. Botox is more than meets the eye
    By Max in forum Pain
    Replies: 0
    Last Post: 06-25-2003, 03:25 PM
  4. Botox not just for beauty
    By Max in forum Care
    Replies: 0
    Last Post: 03-23-2003, 04:44 PM
  5. Wine, Cheese and a Bit of Botox
    By Max in forum Health & Science News
    Replies: 4
    Last Post: 08-12-2002, 03:38 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •