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Abstract
Botulinum A toxin is a potent inhibitor of acetylcholine on the presynaptic level and widely used in the treatment of focal dystonias. Recently, local and systemic side effects on the autonomic nervous system after botulinum A toxin treatment have been suggested. To evaluate possible side effects on the pupillary reflexes, we measured diameter and light evoked changes of the pupil by using static and dynamic pupillometry before and after treatment with botulinum A toxin on days 1,8, 15, and 22 in nine torticollis and seven blepharospasm patients. Patients were treated with either 12.5 ng (torticollis group) or 2.5 ng botulinum A toxin (blepharospasm group). Pupillary diameter as well as light evoked changes showed no relevant fluctuations during the observed period in both diagnostic groups, suggesting that botulinum A toxin may be safely used in the treatment of focal dystonias.