Iatrogenic botulism due to therapeutic botulinum toxin A injection in a pediatric patient

Abstract

Botulinum toxin A is commonly used to reduce spasticity and dystonia in children with cerebral palsy. We report a pediatric patient who developed systemic botulism as a result of a severe overdose of the injected toxin (40 U/kg). This case highlights the importance of physicians having adequate knowledge of primate and human literature on the lethal dose, 50% of botulinum toxin A before injecting children. © 2007 Lippincott Williams & Wilkins, Inc.