Complications

Complication
Timeframe
Likelihood
long term
high

Symptoms related directly to induced muscular weakness, including significant dysphagia.

long term
high

Depression occurs in up to one half of patients.[58]

Depression in adults

long term
medium

Reported to occur in up to 39% of patients in long-term series.[61]

Treatment is of underlying dystonia, with physiotherapy or, in severe cases, with surgery.

Scoliosis

long term
medium

In one series, 32% of patients developed cervical radiculopathy.[61]

Degenerative cervical spine disease

long term
medium

Manifestations of multi-focal or generalised dystonia may emerge in 20% to 30% of patients.[1][56]

long term
low

The rate of antibody development is low (<2%).

Using the lowest effective dose of botulinum toxin and temporally spacing injections by at least 3 months may reduce the risk of antibody formation.[39]

When present, antibody formation manifests as lost efficacy of toxin injections.

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