This article presents 2 cases of different neuropathic trigeminal pain conditions treated with intraoral botulinum toxin injections. [ncbi.nlm.nih.gov]

• Fever

  The classic triad of botulism consists of acute, symmetric, descending flaccid paralysis with prominent bulbar palsies; absence of fever; and clear sensorium. [medscape.com]

  […] arenaviruses, Lassa (Lassa fever), Junin (Argentine hemorrhagic fever) and related viruses. [cdc.gov]

  Botulism poisoning does not cause fever. Patients typically are fully alert and aware of their situation. Although the patient's muscles may be paralyzed, they can still feel pain, temperature, and touch. [centerforhealthsecurity.org]

  […] drooping eyelids; any other abnormal facial change; have symptoms of a urinary tract infection (UTI) and are being treated for urinary incontinence (symptoms of a urinary tract infection may include pain or burning with urination, frequent urination, or fever [botox.com]

  Kostov, another Bulgarian defector developed a raging fever, but recovered. Acting on a hunch the British examined an X-ray of Kostov's back and discovered a pellet identical to that which had been taken from Markov's thigh. [strategypage.com]

• Swelling

  Reddening and swellings may appear at the points of injection but due to follow-up treatment with the cooling mask these can be kept down to a minimum. [groisman-laube.de]

  Signs of this can be hives, shortness of breath, or swelling in your lower legs. Although there's no confirmed case where Botox spread to other parts of the body, it is possible and could be deadly. The medication label includes this warning. [webmd.com]

  Other side effects of BOTOX ® and BOTOX ® Cosmetic include: dry mouth, discomfort or pain at injection site, tiredness, headache, neck pain, eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of eyelids, dry eyes [botox.com]

  Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. [who.int]

  Other side effects of BOTOX ® and BOTOX ® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids [web.archive.org]

• Fatigue

  In contrast, fatigue scores were significantly reduced after Btx-A injections. Conclusion Btx-A injections resulted in no significant functional motor improvement for HSP, but fatigue improved after treatment. [ncbi.nlm.nih.gov]

  Patients who survive botulism may have fatigue and shortness of breath for years afterward, and may need long-term therapy to help them recover. Interested in learning more? See CDC’s information for healthcare providers. [cdc.gov]

  Muscle fatigue and shortness of breath can persist for years. Treatment and Prophylaxis There is no post-exposure prophylaxis available for persons exposed to botulinum toxin. [centerforhealthsecurity.org]

  Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking. Vomiting, diarrhoea, constipation and abdominal swelling may also occur. [who.int]

• Falling

  Because no antidote has yet been created, the gene sequence behind the protein remains a secret, as the researchers who discovered it fear it could fall into the wrong hands. The new toxin has been classified as botulinum toxin H. [medicaldaily.com]

  Length of follow-up: 12 weeks Loss-to-follow-up: Intervention: N 1 (12.5%) Reason: fractured his left humerus after a fall, six weeks after enrolment Control: N 0 (0%) Incomplete outcome data: Intervention: N 0 (0%) Reasons (describe) Control: N 0 (0% [richtlijnendatabase.nl]

• Ecchymosis

  For the management of blepharospasm, inject initial dose at each site without EMG guidance into the medial and lateral pretarsal orbicularis oculi of the upper lid and into lateral pretarsal orbicularis oculi of the lower lid. 1 65 Reduce or prevent ecchymosis [drugs.com]

• Nausea

  This often results in sweating, nausea, and vomiting. [doi.org]

  Migraines, an intense pulsing or throbbing pain in one area of the head, are often accompanied by nausea, vomiting and sensitivity to light and sound, doctors say. [us.cnn.com]

  For example, in the event of a covert release of the contagious variola virus, patients will appear in doctors' offices, clinics, and emergency rooms during the first or second week, complaining of fever, back pain, headache, nausea, and other symptoms [cdc.gov]

  […] musculoskeletal stiffness, 1 muscular weakness, 1 bronchitis, 1 myalgia, 1 musculoskeletal pain, 1 injection-site pain, 1 facial paresis, 1 muscle spasms, 1 hypertension. 1 Management of upper limb spasticity: Pain in extremity, 1 muscular weakness, 1 nausea [drugs.com]

• Sialorrhea

  The clinical signs were severe dysphagia, fed by PEG (FOIS 1; PAS 7), sialorrhea, trismus and ataxia. [ncbi.nlm.nih.gov]

  3CompletedTreatment Blepharospasm 2 3CompletedTreatment Canthal Lines 1 3CompletedTreatment Cerebral Palsy (CP) 1 3CompletedTreatment Cerebral Palsy (CP) / Children / Muscle Spasticity 2 3CompletedTreatment Cerebral Palsy (CP) / Chronic Troublesome Sialorrhea [drugbank.ca]

  Bushara, Sialorrhea in amyotrophic lateral sclerosis: a hypothesis of a new treatment - botulinum toxin A injections of the parotid glands, Medical Hypotheses, 10.1016/S0306-9877(97)90103-1, 48, 4, (337-339), (1997). [doi.org]

  Botulinum toxin B reduces sialorrhea in parkinsonism. Mov Disord. 2003; 18:1059-61. http://www.ncbi.nlm.nih.gov/pubmed/14502678?dopt=AbstractPlus 321. Fehlings D, Rang M, Glazier J et al. [drugs.com]

• Hypersalivation

  When BT is used to treat hyperhidrosis, hypersalivation, hyperlacrimation or when BT-B adverse effects, such as dryness of eye or mucosal dryness occurs [Dressler and Benecke, 2003], exocrine glandular tissue is affected by BT. [doi.org]

• Erythema

  BACKGROUND: Persistent erythema and severe rosacea flushing can cause significant physical discomfort and emotional stress to patients. Currently, no satisfactory treatments are available. [ncbi.nlm.nih.gov]

  Available SuspendedTreatment Pain NOS 1 Not Available Terminated Not Available Cerebral Palsy (CP) 1 Not Available TerminatedTreatment Brain Injury / Stiff Knee Gait 1 Not Available TerminatedTreatment Equinus Contracture 1 Not Available TerminatedTreatment Erythema [drugbank.ca]

  Blepharoptosis (eyelid ptosis), 5 64 140 144 150 296 facial pain, 5 muscular weakness, 5 142 facial paresis. 5 Cosmesis of lateral canthal lines: Eyelid edema. 5 Injection-site reactions: Pain, 5 infection, 5 inflammation, 5 tenderness, 5 swelling, 5 erythema [drugs.com]

• Urticaria

  […] fatalities, reported in patients receiving onabotulinumtoxinA injections directly into salivary glands, the orolingualpharyngeal region, esophagus, or stomach. 1 5 Sensitivity Reactions Serious and/or immediate hypersensitivity reactions (e.g., anaphylaxis, urticaria [drugs.com]

• Torticollis

  KEYWORDS: Botulinum toxin type A; Congenital muscular torticollis; Fibrosis [ncbi.nlm.nih.gov]

  Psychosocial factors and depression in torticollis. J Psychosom Res 1991; 35(4/5): 493–507 PubMed CrossRef Google Scholar 4. Jahanshahi M, Marsden CD. Depression in torticollis: a controlled study. [doi.org]

• Muscle Spasm

  When locally injected in small amounts, Botox blocks the release of the neurotransmitter acetylcholine, interfering with a muscle’s ability to contract. It is used to treat severe muscle spasms or severe, uncontrollable sweating. [britannica.com]

  For nearly 13 years, until the introduction of Botox Cosmetic in 2002, the only FDA-approved uses of Botox were for crossed eyes (strabismus) and abnormal muscle spasms of the eyelids (blepharospasm). [ncbi.nlm.nih.gov]

  Others can no longer speak; some suffer debilitating muscle spasms that contort their faces or necks. Desperate patients are traveling to Canada or England to obtain the experimental drug, made of botulinum toxin. [nytimes.com]

  Botox, made by Allergan Inc. of Irvine, Calif., is approved for treating muscle spasms in the neck, eye and foot, muscle pain and excessive sweating in Canada. Botox Cosmetic, which is made by the same company, is approved to treat facial wrinkling. [web.archive.org]

• Muscle Spasticity

  Hypertrophy of 1 2CompletedTreatment Motor Neurone Disease / Muscle Spasticity / Strokes 1 2CompletedTreatment Muscle Contracture / Muscle Spasticity / Strokes 1 2CompletedTreatment Muscle Spasticity / Strokes 2 2CompletedTreatment Myofascial Pain Syndromes [drugbank.ca]

  BACKGROUND: Botulinum toxin A treatment involves injecting botulinum toxin A to relax muscle spasticity. [ncbi.nlm.nih.gov]

• Muscle Cramp

  Hyperactivity 1 2CompletedTreatment Diabetes Mellitus (DM) / Muscle Cramps Aggravated 1 2CompletedTreatment Disease, Chronic / Nasal Polyposis / Rhinitis 1 2CompletedTreatment Dysfunctional Voiding 1 2CompletedTreatment Essential Tremor of the Upper [drugbank.ca]

• Diplopia

  Four days after BTA injection, diplopia and esotropia developed on her right eye. KEYWORDS: Botulinum toxins; diplopia; esotropia; strabismus [ncbi.nlm.nih.gov]

  Botulinum Toxin type A can give temporary symptomatic relief in many instances of bothersome diplopia irrespective of the cause. Ptosis and acquired vertical deviations are the commonest complications encountered. [doi.org]

• Blepharoptosis

  Temporary blepharoptosis and eyebrow ptosis are rare complications that are technique-dependent; incidence declines as injector skill improves. [ncbi.nlm.nih.gov]

  Compared with placebo, botulinum toxin A was associated with a greater frequency of blepharoptosis, skin tightness, paresthesias, neck stiffness, muscle weakness, and neck pain. [doi.org]

  […] eye, 22 24 60 blurred vision, 1 7 9 22 34 diplopia, 1 7 9 22 24 33 53 181 entropion, 1 9 conjunctivitis, 29 increased tearing. 1 9 34 60 Management of strabismus: Ptosis, 1 9 33 34 37 60 vertical deviation. 1 9 33 34 37 60 Cosmesis of glabellar lines: Blepharoptosis [drugs.com]

• Dystonia

  KEYWORDS: Botulinum toxin; Cranial-facial dystonia; Lingual dystonia; Oromandibular dystonia [ncbi.nlm.nih.gov]

• Headache

  […] with chronic migraine headaches (n = 1508, −2.30 headaches per month; 95% CI, −3.66 to −0.94; 5 studies). [doi.org]

  BACKGROUND: Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an unusual cause of headache, mainly described in older adults, and is rare in children. [ncbi.nlm.nih.gov]

  […] or specifically for headache 106 patients, mostly women, 30-60 years old Prophylactic or acute injections per standards for hyperfunctional facial lines Glabellar frontal temporal, suboccipital as indicated by headache characteristics Varied; ranged [jaoa.org]

• Tremor

  It is this individualized muscle selection and toxin dosing (requiring injection within various sites of a single muscle) that has allowed for success in the management of tremors. KEYWORDS: botulinum toxin; limb tremors; muscle selection [ncbi.nlm.nih.gov]

• Hyperactivity

  We thus conclude that Botulinum toxin is a therapeutic option for the pain associated with radiation-induced peripheral nerve hyperactivity. [ncbi.nlm.nih.gov]

  Hence, the clinician diagnosed that her gummy smile was due to hyperactive lip elevator muscles. [doi.org]

  A lot of facial wrinkles develop as the result of unconscious hyperactivity of the tiny facial muscles. Botulinum toxin, is produced by the bacterium Clostridium botulinum. [goldstadt-privatklinik.de]

• Upper Extremity Spasticity

  The degree of spasticity was assessed via the Modified Ashworth Scale and the upper limb motor function via the Fugl Meyer Upper Extremity Scale at the baseline and 4 and 12 weeks after the botulinum toxin type A injection. [ncbi.nlm.nih.gov]

  upper extremity functional abilities or range of motion at a joint affected by a fixed contracture. 1 Not intended to substitute for usual standard-of-care rehabilitation regimens. 1 Lower Limb Spasticity Treatment of lower limb spasticity to decrease [drugs.com]

Abstract Botulinum toxin (BoNT) injections into facial and bulbar muscles are widely and increasingly used as medical treatments for cervical and facial dystonia, facial hemispasm, correction of facial palsy, hyperhidrosis, as well as cosmetic treatment [ncbi.nlm.nih.gov]

[…] of Adult Onset Spasmodic Torticollis/Cervical Dystonia; Reduction of Glabellar Rhytides Treatment of Cervical Dystonia, Severe Primary Axillary Hyperhidrosis, Glabellar Lines, Blepharospasm, Strabismus Treatment of Glabellar Lines Treatment of Spasticity [chem.nlm.nih.gov]

Sustained TMJ dislocation is not amenable to manual reduction alone when the etiology is muscular in nature. [ncbi.nlm.nih.gov]

If requested by a state health agency, CDC will deploy response teams to investigate unexplained or suspicious illnesses or unusual etiologic agents and provide on-site consultation regarding medical management and disease control. [cdc.gov]

Several etiologic factors have been proposed in the literature; these include skeletal, gingival, and muscular factors that may occur alone or in combination.1,2 Although vertical maxillary dental and/ or skeletal excess3–5 or gingival problems from delayed [doi.org]

Nocturnal Bruxism 1 2RecruitingTreatment Obstructed Defecation Syndrome (ODS) 1 2RecruitingTreatment Overactive Bladder With Urinary Incontinence / Urinary Incontinence (UI) 1 2RecruitingTreatment Painful Unilateral Femorotibial Knee Osteoarthritis of Any Etiology [drugbank.ca]

Effective response to a deliberate release of botulinum toxin will depend on timely clinical diagnosis, case reporting, and epidemiological investigation. [ncbi.nlm.nih.gov]

Preparing public health agencies for chemical attacks Steps in Preparing for Chemical Attacks Enhance epidemiologic capacity for detecting and responding to chemical attacks. [cdc.gov]

Background: Pharmacological management of cervical dystonia (CD) is considered to be symptomatic in effect, rather than targeting the underlying pathophysiology of the disease. [ncbi.nlm.nih.gov]

Pathophysiology of migraine and tension-type headache. Curr Opin Neurol 1994 ; 7: 272 – 7. Google Scholar | Medline 9.. Biary, N, Koller, W, Langenberg, P. Correlation between essential tremor and migraine headache. [doi.org]

Jia-Fong Jhang and Hann-Chorng Kuo, Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action, Toxins, 10.3390/toxins8040120, 8, 4, (120), (2016). [dx.doi.org]

We now know that peripherally delivered BoNTs are taken up in sensory afferents and transported to cleave SNARE proteins in the ganglion and TNC, prevent evoked afferent release and downstream activation. [ncbi.nlm.nih.gov]

Prevention Prevention of foodborne botulism is based on good practice in food preparation particularly during heating/sterilization and hygiene. [who.int]

Silberstein SD, Goadsby PJ: Migraine: preventive treatment. Cephalalgia 2002, 22 :491–512. CrossRef PubMed Google Scholar 6. [doi.org]