Pain and remote weakness in limbs injected with botulinum toxin A for writer's cramp

Sheean, G L
Murray, N M F
Marsden, C D

National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK (G L Sheean FRACP; N M F Murray FRCP; Prof C D Marsden Dsc)
Correspondence to: Dr G L Sheean

The Lancet 346(8968):p 154-156, July 15, 1995.

We describe two cases of a syndrome resembling neuralgic amyotrophy that occurred in limbs injected with botulinum toxin for writer's cramp.In both cases, one of the injections was followed by pain and the next, 7-10 weeks later, by weakness. We believe that unexplained pain in the shoulder region after an injection of botulinum toxin contraindicates a second injection.

Lancet 1995; 346

154-56