A Case of Acute Pulmonary Complication due to Botulinum Toxin: Patient
with Central Pontine Myelinolysis Developed Acute Respiratory Distress
Syndrome after Botulinum Neurotoxin Type A Injection Into Spastic Lower
Extremity Muscles
Abstract
Purpose Chemodenervation with botulinum neurotoxin type A (BoNTA) is the
preferred method for focal spasticity management among various treatment
options. While BoNTA injection is considered safe, its widespread use
and increasing evidence raise safety concerns. Case In this paper, we
present a patient with central pontine myelinolysis, a rare disease, who
developed Acute Respiratory Distress Syndrome (ARDS) on the third day
after BoNTA application to the spastic gastrocnemius muscle group and
required intubation in the intensive care unit due to this complication.
Conclusion To our knowledge, this is the first case reported in the
literature to develop an acute pulmonary complication after BoNTA
injection into spastic lower extremity muscles.