Distant effects of local injection of botulinum toxin

Dale J. Lange, Mitchell F. Brin, Carolyn L. Warner, Stanley Fahn, Robert E. Lovelace

Research output: Contribution to journalArticlepeer-review

143 Scopus citations


We studied five patients who received local injections of botulinum toxin for dystonic disorders to determine if there had been any distant effect on neuromuscular transmission. No patient developed weakness or abnormalities on routine electrophysiologic testing. In all patients who received more than 245 U of toxin, SFEMG in the extensor digitorum communis muscle, a muscle distant to all those injected, was abnormal. Fiber density was increased in the two patients who received the largest cumulative dose. Jitter was maximally increased at slow firing rates, confirming its presynaptic basis. Our results reveal that there is an effect on neuromuscular transmission in muscles distant to those injected with botulinum toxin for dystonia.

Original languageEnglish
Pages (from-to)552-555
Number of pages4
JournalMuscle and Nerve
Issue number6
StatePublished - 1987
Externally publishedYes


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