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An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect

Year 2025, Volume: 16 Issue: 2, 80 - 82, 29.06.2025

Abstract

İntroduction: Botulinum toxin inhibits acetylcholine release at the neuromuscular junction, thereby reducing muscle contraction. Although it was initially used therapeutically to treat strabismus, its clinical role has expanded rapidly over the years and its range of use has expanded to include the treatment of various musculoskeletal, neurological disorders and dermatologic and cosmetic areas.

Case Report: A previously healthy 34-year-old woman presented to the emergency department with complaints of diplopia and slurred speech that started about 4 hours ago. It was learned that the patient had her 4th botox procedure 6 days ago for wrinkles on the glabella, nasal tip and around the eyes. Following a 12-day inpatient stay, the patient was discharged to outpatient care as their symptoms improved.

Conclusion: Treatment of side effects of botulinum toxin primarily involves administration of botulinum antidote, close neurologic and respiratory monitoring and supportive care. The most important step of treatment is antitoxin administration and the earlier it is administered, the better the clinical response. The paralytic effect of the neurotoxin usually ends within 2-6 months. With this case report, we tried to emphasize the possible serious side effects of botulinum toxin, which is frequently used in different fields today.

References

  • 1. Anandan C, Jankovic J. Botulinum toxin treatment in parkinsonism. J Neurol Sci. 2023 Jan 15;456:122810. doi: 10.1016/j.jns.2023.122810.
  • 2. Bach K, Simman R. The multispecialty toxin: a literature review of botulinum toxin. Plast Reconstr Surg Glob Open. 2022 Apr;10(4):e4228. doi: 10.1097/GOX.0000000000004228.
  • 3. Eser F, et al. Iatrogenic botulism cases after gastric and axillary application of botulinum toxin and review of literature. J Infect Dev Ctries. 2024 Mar 31;18(3):480-7. doi: 10.3855/jidc.18868.
  • 4. Ohno K, Engel AG. Congenital myasthenic syndromes. Brain. 2008 Dec;131(Pt 12):3173-224. doi: 10.1093/brain/awn264.
  • 5. Patel BC, Holds JB, Anderson RL. Pyridostigmine for reversal of severe sequelae from botulinum toxin injection. Ophthal Plast Reconstr Surg. 2014 Jan;30(1):e1-3. doi: 10.1097/IOP.0b013e3182a2521f.
  • 6. Meretsky CR, Umali JP, Schiuma AT. A Systematic Review and Comparative Analysis of Botox Treatment in Aesthetic and Therapeutic Applications: Advantages, Disadvantages, and Patient Outcomes. Cureus. 2024 Aug;16(8):e64485. doi: 10.7759/cureus.64485.
  • 7. Dawson EF, et al. From Botox Party to Botulism: A Case Report and Public Health Warning on Adulterated Botulinum Toxin Injection. Cureus. 2024 Aug;16(8):e64887. doi: 10.7759/cureus.64887.
  • 8. Sekertzı S. Clinical therapeutic applications of botulinum toxin in dentistry. Dent Med J-Rev. 2022 Sep 30;4(3):205-16
  • 9. Sheen D, Clarkson E. Botox and dermal fillers: Review and its role in the dental office. Dent Clin North Am. 2020 Apr;64(2):325-39. doi: 10.1016/j.cden.2019.12.002.
  • 10. Kroumpouzos G, et al. Complications of botulinum toxin A: An update review. J Cosmet Dermatol. 2021 Jun;20(6):1585-90. doi: 10.1111/jocd.14160.

Artan Kozmetik Kaygının Beklenmedik Sonucu: Botilinum Toksini Yan Etkisi

Year 2025, Volume: 16 Issue: 2, 80 - 82, 29.06.2025

Abstract

Giriş: Botulinum toksini nöromüsküler kavşakta asetilkolin salınımını inhibe ederek kas kasılmasını azaltır. Başlangıçta şaşılığı tedavi etmek için terapötik olarak kullanılmasına rağmen, yıllar içinde klinik rolü hızla genişledi ve kullanım alanı çeşitli kas-iskelet sistemi, nörolojik rahatsızlıklar ve dermatolojik ve kozmetik alanların tedavisini de içerecek şekilde genişledi.

Olgu Sunumu: Daha önce sağlıklı olan 34 yaşında bir kadın, yaklaşık 4 saat önce başlayan diplopi ve peltek konuşma şikayetleriyle acil servise başvurdu. Hastanın 6 gün önce glabella, burun ucu ve göz çevresindeki kırışıklıklar için 4. botoks işlemini yaptırdığı öğrenildi. 12 günlük bir yatıştan sonra, semptomları düzelen hasta ayaktan tedavi hizmetine alındı.

Sonuç: Botulinum toksininin yan etkilerinin tedavisi öncelikle botulinum antidotunun uygulanmasını, yakın nörolojik ve solunum takibini ve destekleyici bakımı içerir. Tedavinin en önemli adımı antitoksin uygulamasıdır ve ne kadar erken uygulanırsa klinik yanıt o kadar iyi olur. Nörotoksinin paralitik etkisi genellikle 2-6 ay içinde sona erer. Bu vaka sunumuyla, günümüzde farklı alanlarda sıklıkla kullanılan botulinum toksininin olası ciddi yan etkilerini vurgulamaya çalıştık.

References

  • 1. Anandan C, Jankovic J. Botulinum toxin treatment in parkinsonism. J Neurol Sci. 2023 Jan 15;456:122810. doi: 10.1016/j.jns.2023.122810.
  • 2. Bach K, Simman R. The multispecialty toxin: a literature review of botulinum toxin. Plast Reconstr Surg Glob Open. 2022 Apr;10(4):e4228. doi: 10.1097/GOX.0000000000004228.
  • 3. Eser F, et al. Iatrogenic botulism cases after gastric and axillary application of botulinum toxin and review of literature. J Infect Dev Ctries. 2024 Mar 31;18(3):480-7. doi: 10.3855/jidc.18868.
  • 4. Ohno K, Engel AG. Congenital myasthenic syndromes. Brain. 2008 Dec;131(Pt 12):3173-224. doi: 10.1093/brain/awn264.
  • 5. Patel BC, Holds JB, Anderson RL. Pyridostigmine for reversal of severe sequelae from botulinum toxin injection. Ophthal Plast Reconstr Surg. 2014 Jan;30(1):e1-3. doi: 10.1097/IOP.0b013e3182a2521f.
  • 6. Meretsky CR, Umali JP, Schiuma AT. A Systematic Review and Comparative Analysis of Botox Treatment in Aesthetic and Therapeutic Applications: Advantages, Disadvantages, and Patient Outcomes. Cureus. 2024 Aug;16(8):e64485. doi: 10.7759/cureus.64485.
  • 7. Dawson EF, et al. From Botox Party to Botulism: A Case Report and Public Health Warning on Adulterated Botulinum Toxin Injection. Cureus. 2024 Aug;16(8):e64887. doi: 10.7759/cureus.64887.
  • 8. Sekertzı S. Clinical therapeutic applications of botulinum toxin in dentistry. Dent Med J-Rev. 2022 Sep 30;4(3):205-16
  • 9. Sheen D, Clarkson E. Botox and dermal fillers: Review and its role in the dental office. Dent Clin North Am. 2020 Apr;64(2):325-39. doi: 10.1016/j.cden.2019.12.002.
  • 10. Kroumpouzos G, et al. Complications of botulinum toxin A: An update review. J Cosmet Dermatol. 2021 Jun;20(6):1585-90. doi: 10.1111/jocd.14160.
There are 10 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Case Report
Authors

Gözde Yılmaz Dursun 0009-0003-0032-4398

Haticenur Yıldırım 0009-0003-9990-6928

Rukiye Aytekin Akdağ 0009-0007-7139-1562

Necmi Baykan 0000-0002-6845-9550

Ömer Salt 0000-0002-5557-6627

Publication Date June 29, 2025
Submission Date February 2, 2025
Acceptance Date May 7, 2025
Published in Issue Year 2025 Volume: 16 Issue: 2

Cite

APA Yılmaz Dursun, G., Yıldırım, H., Aytekin Akdağ, R., Baykan, N., et al. (2025). An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect. Journal of Emergency Medicine Case Reports, 16(2), 80-82. https://doi.org/10.33706/jemcr.1631738
AMA Yılmaz Dursun G, Yıldırım H, Aytekin Akdağ R, Baykan N, Salt Ö. An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect. Journal of Emergency Medicine Case Reports. June 2025;16(2):80-82. doi:10.33706/jemcr.1631738
Chicago Yılmaz Dursun, Gözde, Haticenur Yıldırım, Rukiye Aytekin Akdağ, Necmi Baykan, and Ömer Salt. “An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect”. Journal of Emergency Medicine Case Reports 16, no. 2 (June 2025): 80-82. https://doi.org/10.33706/jemcr.1631738.
EndNote Yılmaz Dursun G, Yıldırım H, Aytekin Akdağ R, Baykan N, Salt Ö (June 1, 2025) An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect. Journal of Emergency Medicine Case Reports 16 2 80–82.
IEEE G. Yılmaz Dursun, H. Yıldırım, R. Aytekin Akdağ, N. Baykan, and Ö. Salt, “An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect”, Journal of Emergency Medicine Case Reports, vol. 16, no. 2, pp. 80–82, 2025, doi: 10.33706/jemcr.1631738.
ISNAD Yılmaz Dursun, Gözde et al. “An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect”. Journal of Emergency Medicine Case Reports 16/2 (June 2025), 80-82. https://doi.org/10.33706/jemcr.1631738.
JAMA Yılmaz Dursun G, Yıldırım H, Aytekin Akdağ R, Baykan N, Salt Ö. An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect. Journal of Emergency Medicine Case Reports. 2025;16:80–82.
MLA Yılmaz Dursun, Gözde et al. “An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect”. Journal of Emergency Medicine Case Reports, vol. 16, no. 2, 2025, pp. 80-82, doi:10.33706/jemcr.1631738.
Vancouver Yılmaz Dursun G, Yıldırım H, Aytekin Akdağ R, Baykan N, Salt Ö. An Unexpected Result of Increased Cosmetic Anxiety: Botulinum Toxin Side Effect. Journal of Emergency Medicine Case Reports. 2025;16(2):80-2.