Adverse Event Profiles of High Dose Botulinum Toxin Injections for Spasticity.

摘要: Background Botulinum toxin injections are effective in relieving focal spasticity resulting from upper motor neuron injuries. Doses approved the United States for onabotulinumtoxinA and incobotulinumtoxinA up to 400 units, yet higher doses often used. Objective To determine differences risk of adverse events when using (>600 units) as compared lower within clinically applicable categories; difference between types botulinum toxin-A, any association injection cervical muscles with increased events. Design setting Retrospective analysis performed over a 3-year period at freestanding rehabilitation hospital network. Participants Persons or dystonia undergoing ona- and/or injections. Interventions Not applicable. Main outcome measures Adverse were divided into three dose ranges (≤400 401-600 > 600 units). Results 889 342 patients met inclusion criteria 65% ≤400 21% 14% >600 units. not significantly units relative (OR 0.97, 95% CI 0.31, 2.98). associated 2.98, 1.12, 8.13). There no significant event rates (P >.99). Inclusion isolation did increase 4.21, 1.15, 15.46). Conclusion Risk suggesting that current bound may need be reexamined. above found rate effects clinical benefit versus should taken account. Level evidence III.