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Patients with underlying neurological disorders or swallowing difficulties are at some increased risk of side-effects from botulinum toxin products and should be treated and monitored with extreme caution, product manufacturers have warned.
They manufacturers say serious adverse events related to distant spread of botulinum toxin, including muscle weakness, dysphagia and aspiration, have been reported very rarely with all botulinum toxin products, and there have been very rare reports of adverse events with fatal outcome. The types of patient mentioned are at higher relative risk of these side-effects.
The safety information was communicated to doctors by the manufacturers of these products (Botox