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Polyradiculoneuritis after botulinum toxin therapy for cervical dystonia.
							Article 1 of  two
				
						
		
Burguera JA,
								
Department of Neurology, Hospital Universitari 
								La Fe, Valencia, Spain.
A 40-year-old man with cervical dystonia 
								developed an acute inflammatory demyelinating 
								polyradiculoneuritis after botulinum toxin type 
								A treatment. Some cases of idiopathic brachial 
								plexopathy and polyradiculoneuritis have been 
								reported to date. Although a causal relationship 
								is not firmly established, the clinical temporal 
								profile suggests a pathogenic relationship. In 
								patients with cervical dystonia, further use of 
								type A botulinum toxin should be considered 
								contraindicated, and the use of another type of 
								botulinum toxin should be taken into 
								consideration.
 
								Rinsho Shinkeigaku. 2004 
								Jan;44(1):20-4.
								
								A case report of acute polyradiculoneuritis 
								developing after multiple injections of 
								botulinum toxin for cervical dystonia
								
								
								Onoue H,
								
								Department of Internal Medicine, Section of 
								Neurology, Saga Medical School.
								
								A 68-year-old man receiving four times of 
								injection of botulinum toxin type A for cervical 
								dystonia developed acute polyradiculoneuritis 10 
								weeks after the final injection. He had been 
								complaining of paresthesia in four limbs after 
								the second injection of the treatment. On 
								neurological examination, bilateral facial 
								palsy, bulbar palsy, difficulty of breath, 
								flaccid paralysis of all limbs, sensory 
								disturbance of all modality and areflexia in all 
								limbs, and positive Laseque sign were noted. 
								Albuminocytological dissociation was present in 
								the CSF and the conduction velocity was 
								significantly impaired in all peripheral nerves 
								examined. After receiving two times of 
								intravenous highdose IgG and two times of pulse 
								therapy, his neurological deficits gradually 
								improved. To our knowledge, this is the third 
								case report of acute polyradiculoneuropathy 
								developing after botulinum toxin therapy, 
								suggesting that botulinum toxin therapy is 
								involved in the pathogenesis in our case.
								
								
								PMID: 15199733 [PubMed - indexed for MEDLINE]
								
								
																Clin Neuropharmacol. 2000 Jul-Aug;23(4):226-8.
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