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Updated: Jan 8, 2026

Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
Upper Extremity Muscle Weakness Following Axillary Botox Injection With Sterile Water Reconstitution: A Case Report
Pouria Chaghamirzayi1, Javad Karimi Rozveh1, Mohammad Azizmanesh1
1Clinical Research Development Unit of Shahid Madani Hospital Alborz University of Medical Sciences Karaj Iran.
Abstract:
Severe, unexpected pain during botulinum toxin injection is a critical red flag for reconstitution error. Using sterile water instead of normal saline may cause atypical, wider-spread effects like proximal muscle weakness, even at standard doses. Strict adherence to saline reconstitution is essential to prevent this complication.
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