局部美容注射A型肉毒毒素致全身无力的临床表现与电生理结果分析

CLINICAL AND ELECTROPYHSIOLOGIC CHARACTERISTICS OF GENERALIZED MUSCULAR WEAKNESS FOLLOWING COSMETIC INJECTIONS WITH BOTULINUM TOXIN A

目的:分析探讨美容注射A型肉毒毒素致全身无力的临床表现及电生理结果。方法:选择4例因美容注射A型肉毒毒素后出现全身无力患者的临床表现特点及电生理检测结果进行分析,并行相关文献复习。结果:4例患者均在美容注射A型肉毒毒素后,短时间内出现视物模糊、言语不清、咀嚼吞咽困难及四肢无力等典型的临床中毒症状。电生理检测结果也提示了神经肌肉接头功能障碍,伴或不伴肌源性损害。结论:肉毒素产品的真伪、注射剂量以及注射技术极为关键和重要。在非正规的医疗机构由非专业的人员进行注射美容存在安全隐患,严重者会出现中毒症状。认清肉毒毒素中毒的临床表现及电生理特点,对及时诊断治疗中毒患者尤为关键。

Objective： To analyze the clinical and electrophysiologic characteristics of the generalized muscular weakness following local injections with botulinum toxin A. Methods： The clinical manifestations and electrophysiologic characteristics were analyzed in 4 patients, who had generalized muscular weakness following cosmetic local injections with botulinum toxin A, and the related literatures were reviewed. Results： Four patients developed generalized muscular weakness at one week after local injections with botulinum toxin A. They had blurred vision, dysarthria, dysphagia and limb weakness. The electrophysiologic examinations demonstrated the synaptic abnormality, with or without the phenomema of myopathy. Condusion： Intoxication following cosmetic injections with botulinum toxin A was often due to the over-dose. Familiar with its manifestation, electrophysiologic characters could help clinicians do quick diagnosis and effective therapy.