Li Xueqing, Zhu Zhaowei, Zhu Min, Zheng Yanting
Aesthet Surg J Open Forum. 2025 Apr 24;7:ojaf027. doi: 10.1093/asjof/ojaf027. eCollection 2025.
Botulinum toxin type A (BTA) is commonly used to treat dystonia; however, reports of dystonia caused by BTA are rare. In this case study, the authors aimed to illustrate the instances of dystonia after cosmetic injections of BTA. Three cases were retrospectively analyzed, with follow-up evaluations conducted to assess the development and resolution of symptoms. Injection techniques, including microdroplet and intradermal methods, were examined, and potential hypotheses regarding the etiology of dystonia were explored. Recommendations for mitigating adverse effects were formulated based on the analysis of injection practices, including modifications to dosage, injection-site distribution, and volume. In all cases, patients experienced transient dystonia following BTA injections, with symptoms including muscle spasms and abnormal muscle contractions, which resolved spontaneously or with minor interventions. The findings suggest that the use of microdroplet techniques and careful injection strategies can minimize the risk of such adverse effects. In conclusion, the authors suggest that neurological injury, neuromuscular junction impact, uneven drug distribution, and imbalance between denervation and functional recovery may cause dystonia.
A型肉毒杆菌毒素（BTA）常用于治疗肌张力障碍；然而，由BTA引起的肌张力障碍报告却很罕见。在本病例研究中，作者旨在阐述美容注射BTA后出现肌张力障碍的情况。回顾性分析了3例病例，并进行随访评估以评估症状的发展和缓解情况。研究了包括微滴注射法和皮内注射法在内的注射技术，并探讨了关于肌张力障碍病因的潜在假设。基于对注射操作的分析，制定了减轻不良反应的建议，包括对剂量、注射部位分布和注射量的调整。在所有病例中，患者在BTA注射后均出现短暂性肌张力障碍，症状包括肌肉痉挛和异常肌肉收缩，这些症状可自行缓解或经轻微干预后缓解。研究结果表明，使用微滴注射技术和谨慎的注射策略可将此类不良反应的风险降至最低。总之，作者认为神经损伤、神经肌肉接头影响、药物分布不均以及失神经支配与功能恢复之间的失衡可能导致肌张力障碍。
