Ptosis as a remote effect of therapeutic botulinum toxin B injection

B. A. Racette, G. Lopate, L. Good, S. Sagitto, J. S. Perlmutter

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


The authors report a patient with cervical dystonia, previously treated with botulinum toxin A (BTX-A), who developed bilateral ptosis and difficulty with accommodation only after botulinum toxin B (BTX-B). High-frequency repetitive nerve stimulation of the abductor digiti minimi demonstrated a 34% increment in compound muscle action potential. No increment in 20 people injected with BTX-A and no cases of ptosis in a chart review of 1,606 BTX-A injections for cervical dystonia were found. The authors conclude that systemic spread of BTX-B can cause symptomatic involvement of autonomic neurons.

Original languageEnglish
Pages (from-to)1445-1447
Number of pages3
Issue number9
StatePublished - Nov 12 2002


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