Botulinum Toxin Adverse Events

Abstract Botulinum toxin acts at the neuromuscular junction (motor plaque) blocking the release and effects of acetylcholine (ACh), a neurotransmitter of both the central nervous system (CNS) and the peripheral nervous system (SNP). By inhibiting the release of acetylcholine, botulinum toxin interferes with the nervous impulse and causes a characteristic flaccid paralysis of the muscles. This effect is used to decrease wrinkles of the facial skin and chin providing a smooth appearance and for the treatment of a variety of human syndromes characterized by hyperfunction of selected nerve terminals. Side effects of this treatment are rare, but are essentially related to the active ingredient of the drug or to medical malpractice. These adverse events and their possible therapy are discussed in this chapter.