TY  - JOUR
AU  - Hennen, Christina
AU  - Demir, Seda
AU  - Dafsari, Haidar Salimi
AU  - Wunderlich, Gilbert
AU  - Böll, Boris
AU  - Hüser, Christoph
AU  - Barbe, Michael Thomas
AU  - Fink, Gereon Rudolf
AU  - Rueger, Maria Adele
TI  - Botulism after intragastric botulinum toxin injections for weight reduction
JO  - European journal of neurology
VL  - 30
IS  - 12
SN  - 1351-5101
CY  - Oxford [u.a.]
PB  - Wiley-Blackwell
M1  - FZJ-2023-04884
SP  - 3979 - 3981
PY  - 2023
AB  - Although-considering the risk-benefit ratio-botulinum neurotoxin A (BoNT/A) is unequivocally recommended to treat severe neurological diseases such as dystonia, this has not yet been determined for its endoscopic intragastric injection aimed at weight reduction in obesity. However, severe adverse effects of intragastric BoNT/A had not yet been reported, prompting some European countries to endorse its (off-label) use and treat patients transnationally. We here present three cases of botulism after intragastric BoNT/A injections for obesity treatment in a Turkish hospital. Patients presented with cranial nerve affection, bulbar symptoms, and descending paresis, and benefited from treatment with BoNT antitoxin and pyridostigmine. We assume that iatrogenic botulism was induced by overdosing in combination with toxin spread via the highly vascularized gastric tissue. Of note, within a few weeks, more than 80 cases of iatrogenic botulism were reported across Europe after identical intragastric BoNT/A injections. These cases demonstrate the risks of BoNT/A injections if they are not applied within the limits of evidence-based medicine. There is a need for international guidelines to define the indication and a safe dosing scheme, especially in the context of medical tourism.Keywords: botulinum toxins; botulism; medical tourism; obesity.
LB  - PUB:(DE-HGF)16
C6  - 37584071
UR  - <Go to ISI:>//WOS:001060540500001
DO  - DOI:10.1111/ene.16040
UR  - https://juser.fz-juelich.de/record/1018556
ER  -