Research Hub

***THIS SECTION IS CURRENTLY IN PROGRESS. PLEASE BE PATIENT***

The following is a growing list of medical research related to iatrogenic botulism.

**HINT: It is important to always look for the funding source when looking at any research pertaining to botulinum toxin injections. This is a powerful, $11 billion dollar industry, and thus much of the research is industry-funded. Companies that make BoNT products (and fund a lot of the research for new uses of these products) include Allergan/Abbvie, Galderma/Ipsen, Merz Pharmaceuticals.

Categories:

Understanding Botulism

Iatrogenic Botulism research

Selected Iatrogenic Botulism Case Studies

Botulinum toxin's effects on the CNS

Understanding Botulism

1. Botulism - Eric Johnson

2. Quantitative autonomic testing in the management of botulism

3. Botulism in the United States: A Clinical and Epidemiological Review

   
   

Iatrogenic Botulism Research

1. A review of Iatrogenic Botulism

   Review on IB, signs and symptoms, treatment, etc

2. Clinical analysis of 86 botulism cases caused by cosmetic injections

   Helpful case studies that report some of the most common symptoms reported by IB patients

3. Analysis of clinical challenges and prognostic risk factors for 195 cases of iatrogenic botulism in China

4. A Retrospective Case Series Study of Illegal Cosmetic Iatrogenic Botulism: Outbreak Analysis and Response Lessons

5. Impaired Neuronal Communication Syndrome (INCS) as a novel neurological side effect to Botulinum toxin type A therapy with 16 case reports

   Important paper for understanding the wide range of PNS and CNS symptoms that can occur post-botulinum toxin injections

6. Severe nervous system complications after botulinum toxin type a therapy

   Important paper for understanding CNS conditions that can occur after BoNT injections; includes reviews of neurological impairments reported to the FDA post-BoNT injections

7. Analysis of clinical challenges and prognostic risk factors for 195 cases of iatrogenic botulism in China Large study that details frequent characterstics of iatrogenic botulism, as well as prognostic factors. Bottom line: early antitoxin administration is critical.

8. Frontal alopecia following BoNT injections research article on the type of hair loss that can occur post-BoNT injections

9. Complications of Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis meta-analysis on complications; pay close attention to treatment vs placebo rates of complications

10. Quantitative and Qualitative Analysis of Individual Experiences Post Botulinum Toxin Injection - United Kingdom Survey - survey of BoNT consumers; most common reported symptoms after injections included anxiety, panic attacks, headaches, dizziness, and brain fog

11. Real-life prognosis of neurological complications of botulinum toxin: A nationwide pharmacovigilance study of adverse drug reactions reported in France between 1994 and 2020. A study funded by Merz Pharmaceuticals (makers of Xeomin), investigating incidence rates of neurological complications following BoNT injections

12. The Possible Adverse Effects of Intramuscular Botulinum Toxin Injections and their Management

13. Serious and Long-Term Adverse Events Associated with the Therapeutic and Cosmetic Use of Botulinum Toxin

14. Questionnaire about the Adverse Events and Side Effects Following Botulinum Toxin A Treatment in Patients with Cerebral Palsy

15. Findings From the Great British and Northern Ireland Botulinum Toxin Survey: Treatment Outcomes, Patient Experience, and Regulations From a Cross-Sectional Survey

Selected Iatrogenic Botulism Case Studies

1. Dysphagia and Muscle Weakness Caused by Botulinum Toxin Poisoning after Cosmetic Injection (2025)

2. Iatrogenic Botulism Following Botulinum Toxin Injection in Palmar Hyperhidrosis: A Case Report (2025)

3. Iatrogenic Botulism (2024)

4. Iatrogenic generalized botulism, case report (2024)

5. Iatrogenic botulism cases after gastric and axillary application of botulinum toxin and review of literature (2024)

6. From Beauty to Botulism: A Case Report Highlighting the Rare Risk of Botox Administration (2024)

7. Iatrogenic Botulism after botulinum toxin type A: Five cases (2024)

8. From Botox Party to Botulism: A Case Report and Public Health Warning on Adulterated Botulinum Toxin Injection

9. Severe Botulism after Intragastric Botulinum Toxin-A Injection: A Case Series (2024)

10. Transient Worsening of Dysphagia and Dysarthria after Treatment with Botulinum Toxin Type A (2023)

11. Iatrogenic Botulism: A Case Treated With Botulinum Antitoxin (2023)

12. Iatrogenic botulism – a possible cause of generalised muscular weakness in child (2020)

13. Electrophysiological abnormalities in iatrogenic botulism: Two case reports and review of the literature (2019)

14. Iatrogenic Botulism Outbreak in Egypt due to a Counterfeit Botulinum Toxin A Preparation – A Descriptive Series of Patient Features and Outcome (2018)

15. Case of iatrogenic botulism after botulinotherapy in clinical practice

16. Delayed Antitoxin Treatment of Two Adult Patients with Botulism after Cosmetic Injection of Botulinum Type A Toxin (2016)

17. Rapidly Progressive Muscle Paralysis and Acute Respiratory

    Failure Following Endoscopic Botulinum Toxin Injection (2016)

18. Iatrogenic botulism after the therapeutic use of botulinum toxin-A: a case report and review of the literature (2012)

19. Iatrogenic Botulism After Botulinum Toxin Type A Injections (2010)

20. Iatrogenic Botulism in a Child With Spastic Quadriparesis (2007)

21. Iatrogenic Botulism in an Amateur Weight-Lifter (2006)

22. Botulism in 4 Adults Following Cosmetic Injections With an Unlicensed, Highly Concentrated Botulinum Preparation (2006)

    
    

BoNT's Effects on the CNS

1. Transsynaptic inhibition of spinal transmission by A2 botulinum toxin

2. Control of Autophagosome Axonal Retrograde Flux by Presynaptic Activity Unveiled Using Botulinum Neurotoxin Type A

3. Botulinum Neurotoxins in Central Nervous System: An Overview from Animal Models to Human Therapy.

4. Botulinum neurotoxin A impairs neurotransmission following retrograde transynaptic transport.

5. Brain functional changes in patients with botulism after illegal cosmetic injections of botulinum toxin: A resting-state fMRI study

6. Presynaptic targeting of botulinum neurotoxin type A requires a tripartite PSG-Syt1-SV2 plasma membrane nanocluster for synaptic vesicle entry

7. Direct Central nervous system effects of botulinum neurotoxin

8. More than at the Neuromuscular synapse: Actions of BoNT A in the Central Nervous System

9. Tetanus toxin and botulimum toxin utilize unique mechanisms to enter neurons of the central nervous system

10. Central Nervous System Toxicity after Botulinum Neurotoxin injection

11. Interneuronal Transfer and Distal Action of Tetanus Toxin and Botulinum Neurotoxins A and D in Central Neurons

12. Botulinum Neurotoxin Induces Neurotoxic Microglia Mediated by Exogenous Inflammatory Responses