Open AccessHuman Response to Unintended Intrathecal Injection of Botulinum Toxin
Author(s) -
Carroll Ian,
Fischbein Nancy,
Barad Meredith,
Mackey Sean
Publication year - 2011
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2011.01135.x
Subject(s) - medicine , botulinum toxin , analgesic , anesthesia , intrathecal , toxin , biochemistry , chemistry
Objective. Describe the first reported human intrathecal (IT) botulinum toxin injection. Design. Case report. Setting and Patients. We report here the sequelae to an unintended IT injection of botulinum toxin type B (BTB) in a 60‐year‐old woman with chronic back pain. Results. Following the IT administration of BTB, the patient experienced the onset of symmetric ascending stocking distribution painful dysesthesias, which persisted for approximately 6 months before receding. Objective neurologic deficits were not appreciated, and analgesic effects were prominently absent. Conclusions. Analgesic actions of botulinum toxins in animals and in humans have led to speculation that IT botulinum toxin might exert significant analgesic effects. The unusual and unexpected subsequent clinical course, neurologic sequelae, dysesthesias, and absence of analgesia suggest that botulinum toxin will not be a therapeutic modality to treat pain as proposed by those studying botulinum toxin in animal models.