Sixth nerve palsy following botulinum toxin injection for facial rejuvenation

Abstract

Background: Botulinum toxin A (BTX) has been widely used for a variety of facial esthetic procedures within the last couple of decades. Efficacy and safety of BTX for facial rejuvenation has been extensively studied in multiple randomized prospective controlled trials. Focal weakness is among the most commonly reported adverse effects. Adverse reactions tend to occur most commonly due to errors in dosing formulation and errors with the techniques of the application. No serious long-term complications have been reported.

Main observation: We present the case of a 52-year-old female presenting with diplopia one week following the injection of BTX for facial rejuvenation at glabella, forehead and crow’s feet areas.

Conclusions: Injection of BTX adjacent to periorbital area may be associated with extra-ocular muscle paralysis.

Keywords:

• Botulinum toxin
• diplopia
• sixth nerve palsy
• strabismus

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.