Search Our Scientific Publications & Authors

Semin Neurol 2018 Dec 6;38(6):608-618. Epub 2018 Dec 6.

Department of Neurology, Boston Medical Center, Boston, Massachusetts.

Migraine and tension-type headache (TTH) are common primary disorders that carry significant morbidity and socioeconomic effect. In this article, we will review the epidemiology, presentation, and diagnosis of these disorders. First-line acute treatment for migraine consists of analgesics, triptans, and antiemetics, while nonsteroidal anti-inflammatory drugs are the mainstay treatment for TTH. Read More

Acta Med Port 2018 Nov 30;31(11):691-693. Epub 2018 Nov 30.

Serviço de Medicina Interna. Hospital Sousa Martins. Guarda. Portugal.

Botulism is a serious illness caused by exposure to botulinum toxin. It is manifested by flaccid, paralysis, symmetric and in descending pattern affecting cranial and peripheral nerves. Given the frequent need for invasive mechanical ventilation, these patients should be approached in an intensive care setting. Read More

J Cosmet Dermatol 2018 Dec 5. Epub 2018 Dec 5.

Department of Aesthetic Medicine, Medical University of Bialystok, Bialystok, Poland.

Background: Aesthetic surgery procedures such as lip augmentation, eyelid correction, face-lifting, or Botox treatment for lines and wrinkles are an important part of cosmetic surgery.

Objectives: The aim of the study was to estimate improvement in appearance following plastic surgery using modern collective intelligence methods of validation.

Methods: A total of 108 photographs showing 54 patients prior to and following cosmetic surgery were downloaded from Internet web presentations of several unnamed plastic surgeons. Read More

Pharmacol Res Perspect 2018 Dec 22;6(6):e00446. Epub 2018 Nov 22.

Ipsen Bioinnovation Abingdon Oxford UK.

Botulinum neurotoxin (BoNT) is a major therapeutic agent. Of seven native BoNT serotypes (A to G), only A and B are currently used in the clinic. Here we compared the potency of commercially available purified native serotypes A1 to F1 across in vitro, ex vivo, and in vivo assays. Read More

Acta Physiol (Oxf) 2018 Dec 3:e13230. Epub 2018 Dec 3.

Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.

Aim: Modulation of electrical activity in the subthalamic nucleus has been therapeutically effective in Parkinson's disease. Pharmacological manipulation of glutamate release from subthalamic neurons could also favourably alter basal ganglia activity to improve motor symptoms. The present study investigates the efficacy of selective suppression of hyperactive glutamatergic input from the subthalamic nucleus to the globus pallidus internal segment by botulinum toxin A (BoNT-A) in a parkinsonian model. Read More

Int Urogynecol J 2018 Dec 1. Epub 2018 Dec 1.

Department of Gynecology and Obstetrics, Imam Khomeini Hospital, Fellowship in Pelvic Floor Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Introduction And Hypothesis: Most patients suffering from vaginismus feel sinful, anxious, and incompetent, with reduced self-confidence. This study was aimed at comparing the effectiveness of the physiotherapy of pelvic floor muscles as a standard treatment and local injection of botulinum toxin on the sexual functioning of patients with primary vaginismus.

Methods: In this randomized clinical trial (RCT), the study population included women with primary vaginismus referred to the Sexual Health and Gynecologic Clinics of Imam Khomeini Hospital during 2013-2014. Read More

Maturitas 2019 Jan 22;119:21-24. Epub 2018 Oct 22.

The Royal Women's Hospital, 20 Flemington Road Parkville, Victoria 3052 Australia; The University of Melbourne, Department of Obstetrics and Gynaecology, 7thFloor Royal Women's Hospital, 20 Flemington Road Parkville, Victoria 3052 Australia. Electronic address:

Botulinum toxin, from the bacteria Clostridium botulinum, acts by block the pre-synaptic release of acetylcholine at the neuromuscular junction, resulting in temporary muscle paralysis. There are several clinically available formulations, the most extensively studied being of onabotulinumtoxinA. This article outlines three of the common clinical applications of onabotulinumtoxinA relevant to women's health: the management of symptoms of overactive bladder, chronic migraine and facial lines. Read More

Eur J Pharmacol 2018 Nov 28. Epub 2018 Nov 28.

Department of Pharmacy, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, 266071, China.

The aim of our study was to investigate the effects of a new synthetic compound (E) -1- (E) -1- (2- hydroxy -5- chlorophenyl) -3- (3, 5, 6- three methyl pyrazine -2- based) -2- propylene -1 ketone, Z-11, a tetramethylpyrazine analogue, on cerebral ischemia reperfusion injury and the underlying mechanism. 240~260g adult male Wistar rats were subjected to middle cerebral artery occlusion for 2h, followed by 22h of reperfusion. Z-11 (1. Read More

Gynecol Obstet Fertil Senol 2018 Nov 27. Epub 2018 Nov 27.

Département de gynécologie, hôpital femme-mère-enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69000 Lyon, France; EMR 3738, université Claude-Bernard Lyon 1, 69000 Lyon, France. Electronic address:

Eur J Rheumatol 2018 Dec 12;5(4):224-229. Epub 2018 Oct 12.

Department of Dermatology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.

Objective: Raynaud's phenomenon consists of vasospastic disease of the digital arteries after exposure to cold or stress. It causes an important reduction in the patient's quality of life when severe. The available treatments do not always offer favorable results. Read More

Cureus 2018 Jul 18;10(7):e2999. Epub 2018 Jul 18.

Plastic Surgery, Waldkrankenhaus Bonn, Bonn, DEU.

Background Treatment of the lower eyelid region to rejuvenate the skin or treat actinic elastosis often proves difficult. Established treatment options, such as hyaluronic acid injections, botulinum toxin injections, microneedling, skin resurfacing (microdermabrasion, chemical peel (exfoliation), laser treatment), as well as blepharoplasties and autologous fat transfers, can be associated with significant risks and increased patient burden. Furthermore, they may not be effective for treating the signs of skin aging or actinic elastosis, including dark rings under the eyes, a lack of volume and cutis laxa. Read More

Eurasian J Med 2018 Oct;50(3):164-167

Department of Psychology, Islamic Azad University Ardabil Branch, Ardabil, Iran.

Objective: Body dysmorphic disorder, narcissistic personality disorder, and histrionic personality disorders are the most frequent personality disorders in patients seeking cosmetic interventions. Botulinum toxin type A (BoNTA) injection for cosmetic purpose is the most popular among non-surgical cosmetic procedures and is also the second common aesthetic treatment in Iran. The current study aimed to assess personality disorders in people who were referred for BoNTA injection in Ardabil, Iran. Read More

Sensors (Basel) 2018 Dec 3;18(12). Epub 2018 Dec 3.

Department of Chemistry, KAIST, 291 Daehak-ro, Yuseong-gu, Daejeon 34141, Korea.

The possibility of exposure to botulinum neurotoxin (BoNT), a powerful and potential bioterrorism agent, is considered to be ever increasing. The current gold-standard assay, live-mouse lethality, exhibits high sensitivity but has limitations including long assay times, whereas other assays evince rapidity but lack factors such as real-time monitoring or portability. In this study, we aimed to devise a novel detection system that could detect BoNT at below-nanomolar concentrations in the form of a stretchable biosensor. Read More

J Drugs Dermatol 2018 Nov;17(11):1245-1246

Introduction: Google Search is an important tool for patients researching skin care treatments and finding dermatologists. Data from individual patient’s searches are aggregated by Google and yield powerful data sets that can be used to trend population behaviors. This study investigates the correlations between the volume of Google searches and the number of procedures performed annually for both botulinum toxin type A and hyaluronic acid tissue fillers. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018 ;118(10):108-114

Military Medical Academy n.a. S.M. Kirov, Saint-Petersburg, Russia.

The article presents modern views on the pathophysiology of spasticity, which is a frequent disabling consequence to the upper motor neuron (UMN) damage. Morphological and functional system of motion organization and the changes after the UMN damage is considered. The authors analyze existing definitions of spasticity. Read More

Infect Dis (Lond) 2018 Nov 30:1-5. Epub 2018 Nov 30.

a Department of Food Safety, Nutrition and Veterinary Public Health , Istituto Superiore di Sanità , Rome , Italy.

Foodborne botulism is a life-threatening disease caused by the ingestion of food containing preformed botulinum neurotoxins, the most potent natural poisons known to humans. On the basis of the new challenges in management of the diseases as well as considering the potential use of botulinum toxins as biological weapons, foodborne botulism is still considered a public health emergency. Each suspected case should be immediately notified to public health authorities with the aim of preparing a prompt response. Read More

J Neurosurg 2018 Oct 1:1-4. Epub 2018 Oct 1.

Camptocormia is a rare, involuntary movement disorder, presenting as truncal flexion while standing or walking, and is mainly observed as a feature of Parkinson's disease (PD) and primary dystonia. Deep brain stimulation (DBS) of the globus pallidus internus is effective for refractory camptocormia observed with PD or dystonia. However, the effectiveness of pallidotomy for camptocormia has not been investigated. Read More

Plast Reconstr Surg 2018 Dec;142(6):1520-1522

Ann Arbor, Mich. From the Section of Plastic Surgery and the Department of Biomedical Engineering, University of Michigan.

Plast Reconstr Surg 2018 Dec;142(6):847e-855e

Newport Beach and Fremont, Calif. From Medical Associates; the Center for Dermatology Clinical Research, Inc.; and Bonti, Inc.

Background: Botulinum neurotoxins, which are widely used commercially for therapeutic and cosmetic applications, have historically belonged to serotypes A and B. Serotype E has a distinct profile with a faster onset and shorter duration of effect. EB-001 is a proprietary formulation of serotype E in development for aesthetic (cosmetic) and therapeutic uses. Read More

Plast Reconstr Surg 2018 Nov 21. Epub 2018 Nov 21.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Rep. of Korea.

Background: The frontalis is a representative target muscle for botulinum neurotoxin type A injections aimed at treating horizontal wrinkles in the forehead region. However, a lack of information regarding the shape and thickness of the frontalis may lead to unexpected side effects.

Methods: This study dissected hemifaces of 44 embalmed Korean and Thai cadavers and performed ultrasound examinations on 20 healthy Korean volunteers. Read More

Indian J Dermatol Venereol Leprol 2018 Nov 29. Epub 2018 Nov 29.

Department of Dermatology and Venerology, Del Sureste Hospital Arganda Del Rey, Madrid, Spain.

Toxins (Basel) 2018 Nov 26;10(12). Epub 2018 Nov 26.

Department of Anesthesia and Perioperative Care, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, Room 3C-38, 1001 Potrero Avenue, San Francisco, CA 94110, USA.

Botulism, caused by exposure to one or more of the eight serotypes of botulinum neurotoxins (BoNTs) (BoNT/A through H), is often fatal without rapid treatment. [.. Read More

Glia 2018 Nov 28. Epub 2018 Nov 28.

Institute of Integrative Neuroanatomy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Clostridium botulinum C3 transferase (C3bot) ADP-ribosylates rho proteins to change cellular functions in a variety of cell types including astrocytes and neurons. The intermediate filament protein vimentin as well as transmembrane integrins are involved in internalization of C3bot into cells. The exact contribution, however, of these proteins to binding of C3bot to the cell surface and subsequent cellular uptake remains to be unraveled. Read More

PLoS One 2018 28;13(11):e0207448. Epub 2018 Nov 28.

Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, Shanghai, China.

Background: Botulinum toxin type A (BoNT-A) is generally considered safe and is widely used to treat a variety of clinical conditions involving muscle hyperactivity and for cosmetic purposes. However, the effects of BoNT-A poisoning (botulism) on brain function are poorly understood.

Methodology/principal Findings: Herein, we investigated brain functions in 9 patients who received illegal cosmetic injections of botulinum and 18 matched controls by combining the analysis methods of regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) based on resting-state fMRI. Read More

Front Pharmacol 2018 13;9:1287. Epub 2018 Nov 13.

Institute of Pharmacology and Toxicology, Ulm University Medical Center, Ulm, Germany.

The C2 toxin is an exotoxin causing severe enterotoxic symptoms. The C2 toxin consists of the binding/translocation component C2II, and the enzymatic active component C2I. After proteolytic activation, C2IIa forms heptamers that bind C2I. Read More

J Cell Physiol 2018 Nov 27. Epub 2018 Nov 27.

Cardiology Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.

Botulinum toxin injection on epicardial fat, which inhibits acetylcholine (ACh) release, reduced the presence of atrial fibrillation (AF) in patients after heart surgery. Thus, we wanted to study the profile of the released proteins of epicardial adipose tissue (EAT) under cholinergic activity (ACh treatment) and their value as AF predictors. Biopsies, explants, or primary cultures were obtained from the EAT of 85 patients that underwent open heart surgery. Read More

Urol Case Rep 2019 Jan 25;22:73-75. Epub 2018 Oct 25.

Department of Urology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.

Dermatol Pract Concept 2018 Oct 31;8(4):277-282. Epub 2018 Oct 31.

Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy.

Background: Recent studies have highlighted new botulinum neurotoxin (BoNT) applications in the field of dermatology.

Objective: To review current knowledge of BoNT use in dermatology.

Methods: The literature of the last 5 five years has been reviewed. Read More

Neuroscience 2018 Nov 23. Epub 2018 Nov 23.

Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele, Milano, Italy; IRCCS Humanitas, via Manzoni 56, 20089 Rozzano, Italy. Electronic address:

The process of neurotransmitter release is central to the control of cell-to-cell communication in brain. SNAP-25 is a component of the SNARE complex, which, together with syntaxin-1 and synaptobrevin, mediates synaptic vesicle fusion with the plasma membrane. The genetic ablation of the protein or its proteolytic cleavage by botulinum neurotoxins results in a complete block of synaptic transmission. Read More

J Oral Rehabil 2018 Nov 23. Epub 2018 Nov 23.

Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.

Background: Masseter muscle function influences mandibular bone homeostasis. As previously reported, bone resorption markers increased in the mouse mandibular condyle two days after masseter paralysis induced with botulinum toxin type A (BoNTA), followed by local bone loss.

Objective: This study aimed to evaluate the bone quality of both the mandibular condyle and alveolar process in the mandible of adult mice during the early stage of a BoNTA-induced masseter muscle atrophy, using a combined 3D histomorphometrics and shape analysis approach. Read More

J Neurol 2018 Nov 22. Epub 2018 Nov 22.

Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany.

Background: Urinary involvement is common in hereditary spastic paraplegias (HSPs), but has rarely been assessed systematically.

Methods: We characterized urinary complaints in 71 German HSP patients (mean age 55.4 ± 13. Read More

Dermatol Clin 2019 Jan;37(1):117-128

Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Dermatologic SurgiCenter, 1200 Locust Street, Philadelphia, PA 19107, USA. Electronic address:

Topical silicone gel is more beneficial than petrolatum-based products as an all-purpose wound dressing for granulating and sutured wounds, regardless of cause. Vaginal laser rejuvenation is effective in relieving genitourinary syndrome of menopause, stress urinary incontinence, vaginal relaxation syndrome, and related vulvar disorders. New cosmetic indications in the upper face for onabotulinumtoxinA have been approved by the Food and Drug Administration, whereas off-label treatments in the lower face increase in popularity. Read More

Neurology 2018 Nov 21. Epub 2018 Nov 21.

From the Department of Neurology (P.A., A.J., J.-I.L., M.M., M.R., O.A., H.-P.H., H.H.), Medical Faculty, Heinrich Heine University Düsseldorf; and Toxogen GmbH (D.R., H.B.), Hannover, Germany.

Objective: To investigate the prevalence of neutralizing antibodies (NABs) against botulinum neurotoxin type A (BoNT/A) during long-term BoNT/A treatment in different neurologic indications.

Methods: In this monocentric, observational cross-sectional study, 596 outpatients treated with BoNT/A for different indications were tested for BoNT/A binding antibodies by ELISA. Positive samples were investigated for NABs with the mouse hemidiaphragm test. Read More

Psychol Health Med 2018 Nov 21:1-6. Epub 2018 Nov 21.

a Neurology Department, the First Affiliated Hospital, School of Medicine , Zhejiang University , Hangzhou , Zhejiang Province , P.R. China.

To determine the effects of botulinum toxin type A (BoNT-A) injections on self-esteem and quality of life (QOL) in blepharospasm patients, we enrolled 87 patients into the study. Patients completed the WHOQOL-BREF questionnaire, the Self-Esteem Scale (SES), and the Ocular Surface Disease Index (OSDI) before treatment on the date of enrollment and again after 4 weeks of treatment with BoNT-A. The overall QOL, general health status, the physiological and psychological domain scores of the WHOQOL-BREF, and the SES score significantly improved after treatment. Read More

Ann Plast Surg 2018 Nov 17. Epub 2018 Nov 17.

Craniofacial Research Center, Craniofacial Surgery, Department of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.

Background: Augmentative forehead contouring to create a full rounded smooth forehead is increasingly popular worldwide especially in East Asia where a flat and/or concave irregular forehead is considered unaesthetic. We present our outcomes performing fat transfer to the forehead in combination with botulinum toxin (Botox) corrugator-frontalis injection where indicated in East Asians.

Methods: From 2013 to 2017, 62 consecutive patients with flat and/or concave irregular unaesthetic foreheads underwent forehead fat transfer using a microautologous fat transplantation gun. Read More

J Neurol 2018 Nov 20. Epub 2018 Nov 20.

Academic Department of Neurosciences, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK.

Objective: Dystonia is characterised by sustained muscular contractions frequently producing repetitive, twisting and patterned movements. The primary aim of this systematic review was to establish how quality of life (QoL) is affected in idiopathic focal, multifocal and segmental dystonia. This review aimed to evaluate variations in QoL between different subtypes of dystonia, identify the determinants of QoL and assess the effects of different treatments on QoL. Read More

Clin Case Rep 2018 Nov 26;6(11):2150-2155. Epub 2018 Sep 26.

Department of Neurology and Clinical Neurophysiology (Dystonia Clinic) Bispebjerg University Hospital University of Copenhagen Copenhagen Denmark.

Tardive dystonia is a risk factor in medical antipsychotic treatment. It often begins with repetitive involuntary jaw and tongue movements resulting in impaired chewing and detrimental effect on the dentition. The orofacial dysfunction may go unrecognized in a neurological setting. Read More

Animals (Basel) 2018 Nov 17;8(11). Epub 2018 Nov 17.

College of Agriculture, Communities, and the Environment, Kentucky State University, Frankfort, KY 40601, USA.

To identify differences in rumen function as a result of feeding monensin to beef cattle, rumen fluid metagenomics and metabolomics analyses were used to evaluate the functional attributes and metabolites of rumen microbiota in beef steers fed no or 200 mg/d of monensin. Eight rumen-fistulated steers were used in the study for a period of 53 days. Rumen fluid samples were collected on the last day of the experiment. Read More

J Stomatol Oral Maxillofac Surg 2018 Nov 16. Epub 2018 Nov 16.

Department of Oral and Maxillofacial Surgery, University Hospital of Besançon, boulevard Fleming, 25030 Besançon cedex, France.

Introduction: Hyperactivity of the lateral pterygoid muscle (LPM) is one of the presumed mechanisms of the onset of temporomandibular disorders (TMD) and explains why intramuscular injection of botulinum toxin (BT) may be indicated for treatment. Intramuscular injection without guidance is difficult because of its deep location. The objectives of this study were to determine the feasibility of MR-guided navigation for BT injection in the LPM in TMD and to report about our first results. Read More

J Pediatr Orthop 2018 Nov 16. Epub 2018 Nov 16.

Department of Orthopaedic Surgery, Washington University in St. Louis.

Background: Physical therapy (PT) alone is not always effective for treatment of congenital muscular torticollis (CMT). The adjunctive use of botulinum toxin (BTX) injection into the sternocleidomastoid, followed by PT, could provide correction and avoid more invasive surgery. Aims of the study were to review clinical and caregiver-reported outcomes of children with resistant CMT treated by BTX injection combined with a guided-PT program. Read More

Arch Bronconeumol 2018 Nov 15. Epub 2018 Nov 15.

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China.

Introduction: The endotoxin lipopolysaccharide (LPS)-induced pulmonary endothelial barrier disruption is a key pathogenesis of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). However, the molecular mechanisms underlying LPS-impaired permeability of pulmonary microvascular endothelial cells (PMVECs) are not fully understood.

Methods: Rat PMVECs were isolated and monolayered cultured, then challenged with different doses of LPS (0. Read More

Muscle Nerve 2018 Nov 17. Epub 2018 Nov 17.

Department of Physical Medicine and Rehabilitation, Soonchunhyang University Hospital, Seoul, Korea.

Introduction: The extensor hallucis longus (EHL) muscle is important for diagnosis of neurologic lesions. It is also a target muscle for treatment. We investigated EHL with ultrasonography to determine optimal needle placement for safety and accuracy. Read More

J Biol Chem 2018 Nov 16. Epub 2018 Nov 16.

Pharmacology, Cinvestav-IPN, Department of Pharmacology, Mexico.

G protein-coupled receptors stimulate Rho guanine nucleotide exchange factors that promote mammalian cell migration. Rac and Rho GTPases exert opposing effects on cell morphology, and are stimulated downstream of Gβγ and Gα or Gα, respectively. These Gα subunits might in turn favor Rho pathways by preventing Gβγ signaling to Rac. Read More

J Sex Med 2018 Nov 13. Epub 2018 Nov 13.

Sexual Medicine and Andrology Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy; Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy. Electronic address:

Introduction: Although vaginismus is a condition with a great impact on psychosexual well-being, the evidence on the efficacy of interventions is lacking.

Aim: To review all information on vaginismus treatment, including data from randomized clinical trials (RCTs) and observational studies.

Methods: A systematic search was conducted of MEDLINE, EMBASE, PsycINFO, and ClinicalTrials. Read More

Toxins (Basel) 2018 Nov 15;10(11). Epub 2018 Nov 15.

Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, Agricultural Research Services, United States Department of Agriculture, 800 Buchanan Street, Albany, CA 94710, USA.

Botulinum neurotoxin (BoNT) intoxication can lead to the disease botulism, characterized by flaccid muscle paralysis that can cause respiratory failure and death. Due to the significant morbidity and mortality costs associated with BoNTs high toxicity, developing highly sensitive, rapid, and field-deployable assays are critically important to protect the nation's food supply against either accidental or intentional contamination. We report here that the B-cell based biosensor assay CANARY (Cellular Analysis and Notification of Antigen Risks and Yields) Zephyr detects BoNT/A holotoxin at limits of detection (LOD) of 10. Read More

J Pediatr Gastroenterol Nutr 2018 Nov 15. Epub 2018 Nov 15.

Pediatric Surgery Department, Hôpital La Timone-Enfants, Marseille, France.

Objectives: In Hirschsprung's disease (HD), despite successful surgical treatment, 50% of children experience long-term functional gastrointestinal problems, particularly chronic functional obstructive symptoms. We report our experience regarding clinical effects of neurostimulation-guided anal intrasphincteric botulinum toxin (BT) injections on postoperative obstructive symptoms attributed to a non-relaxing anal sphincter complex in HD patients.

Methods: In this monocenter cohort study, 15 HD patients with postoperative functional intestinal obstructive symptoms received neurostimulation-guided anal intrasphincteric BT injections. Read More

Clin Pract Cases Emerg Med 2018 Nov 28;2(4):330-333. Epub 2018 Sep 28.

University of California, Los Angeles, Department of Emergency Medicine, Los Angeles, California.

We present a case of new-onset bulbar muscle weakness in the setting of therapeutic botulinum injections for spasticity in a teenaged patient with cerebral palsy. Through a careful history, a systemic effect of the local injections was suspected, and the patient's symptoms improved with a decrease in the dosing of the botulinum injections. Read More