From the Guidelines
If you experience symptoms of botulism after receiving Botox injections, seek immediate medical attention, as prompt treatment can significantly improve outcomes in terms of morbidity, mortality, and quality of life. Potential symptoms include difficulty breathing, swallowing, or speaking, muscle weakness, drooping eyelids, blurred vision, and dry mouth, which typically occur within hours to days after treatment 1. While true botulism from cosmetic Botox is extremely rare, any concerning symptoms should be evaluated promptly. Treatment may involve supportive care and, in severe cases, administration of botulism antitoxin, which can mitigate the extent and severity of paralysis and prevent respiratory compromise 1.
Some key points to consider:
- The symptoms of botulism can evolve over a period of hours to a few days, starting with minor visual changes or abdominal discomfort, followed by progressive cranial palsies and potentially descending flaccid bilateral paralysis 1.
- Early gastrointestinal symptoms, such as nausea and vomiting, are more common in foodborne botulism than in other types of botulism, but their presence or absence does not rule out the diagnosis 1.
- Botulism symptoms can occur if the toxin spreads beyond the intended treatment area, emphasizing the importance of receiving Botox only from qualified healthcare providers who use proper techniques and FDA-approved products 1.
- The risk of botulism is minimized when Botox is administered correctly in appropriate doses, and discussing potential side effects with your provider before treatment can help identify normal post-treatment expectations and signs that would warrant medical attention 1.
Given the potential severity of botulism and the importance of prompt treatment, it is crucial to seek immediate medical attention if symptoms occur, as this can significantly impact morbidity, mortality, and quality of life outcomes 1.
From the FDA Drug Label
The symptoms of botulism include: o loss of strength and muscle weakness all over the body o blurred vision and drooping eyelids o trouble saying words clearly o trouble breathing o double vision o hoarseness or change or loss of voice o loss of bladder control o trouble swallowing These symptoms can happen hours, days, or weeks after you receive an injection of JEUVEAU.
The symptoms of botulism after Botox (Botulinum toxin) injection are:
- Loss of strength and muscle weakness all over the body
- Blurred vision and drooping eyelids
- Trouble saying words clearly
- Trouble breathing
- Double vision
- Hoarseness or change or loss of voice
- Loss of bladder control
- Trouble swallowing These problems could make it unsafe for you to drive a car or do other dangerous activities 2.
From the Research
Symptoms of Botulism after Botox Injection
The symptoms of botulism after Botox (Botulinum toxin) injection can be severe and potentially life-threatening. Some of the common symptoms reported in the studies include:
- Dysphagia (difficulty swallowing) 3, 4, 5
- Generalized paralysis or weakness 3, 4, 5
- Respiratory depression or distress 3, 6, 4, 5
- Double vision or blurred vision 7, 4
- Hoarseness 4
- Fatigue 4
- Autonomic dysfunction 6
- External and internal ophthalmoplegia (paralysis of the eye muscles) 6
- Cervical dystonia, severe primary axillary hyperhidrosis, strabismus, neurogenic detrusor over-activity, chronic migraine, upper limb spasticity, and blepharospasm 7
Time of Onset of Symptoms
The symptoms of botulism after Botox injection can appear within a few days to a few weeks after the injection. The time of onset of symptoms reported in the studies includes:
- 3 days postinjection 3
- 2 weeks postinjection 7
- 4-10 days after the application of BoNT-A 4
- 7 and 9 days from symptom onset 3
Treatment of Botulism after Botox Injection
The treatment of botulism after Botox injection typically involves the administration of botulinum antitoxin. The studies report that:
- Early administration of antitoxin is the mainstay of management 3
- Clinical efficacy of botulinum antitoxin treatment was observed in patients who were given the drug 7 and 9 days after the occurrence of symptoms 3
- Pyridostigmine could relieve symptoms of the patient 7
- The use of botulinum antitoxin made a significant contribution to clinical improvement and was recommended if clinical worsening continued, regardless of the time elapsed after BoNT-A application 4