{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:46:55Z","timestamp":1782139615383,"version":"3.54.5"},"reference-count":5,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"Abstract<\/jats:title>Background and purpose<\/jats:title>The recent off\u2010label use of botulinum neurotoxin (BoNT) for intragastric obesity treatment has led to 67 cases of systemic botulism in T\u00fcrkiye, Germany, Austria and Switzerland. This case report highlights the potential risks and adverse effects associated with this treatment.<\/jats:p><\/jats:sec>Case report<\/jats:title>A 36\u2010year\u2010old female presented to the emergency room with shortness of breath, fatigue, difficulty in eating and holding her head, constipation and double vision after receiving intragastric BoNT injection for obesity treatment. She had bilateral orbicularis oculi weakness, facial diplegia, weak tongue, masseter, neck and extremity muscles. Electromyography showed a presynaptic type neuromuscular junction disorder. The patient was admitted to the intensive care unit and administered botulinum heptavalent equine\u2010derived antitoxin, but the medication had to be stopped due to a reaction. The patient was started on pyridostigmine for symptomatic treatment and was transferred to an inpatient clinic after minimal improvement. She was discharged after 7\u2009days of follow\u2010up.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Clinicians should be cautious of the potential risks of intragastric BoNT injection for obesity treatment and consider systemic botulism as a potential adverse effect. Antitoxin treatment should be considered in clinically progressing patients despite negative botulinum toxin testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16005","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T16:14:05Z","timestamp":1690560845000},"page":"3394-3396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Iatrogenic systemic botulism after intragastric botulinum neurotoxin injection: Case report"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4014-0425","authenticated-orcid":false,"given":"Bekir Burak","family":"K\u0131lboz","sequence":"first","affiliation":[{"name":"Department of Neurology, Prof. Dr. Cemil Tascioglu City Hospital University of Health Sciences Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9003-9800","authenticated-orcid":false,"given":"Zekeriya","family":"Ervatan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascioglu City Hospital University of Health Sciences Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-6064","authenticated-orcid":false,"given":"R\u0131dvan","family":"Dumlu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Prof. Dr. Cemil Tascioglu City Hospital University of Health Sciences Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-670X","authenticated-orcid":false,"given":"Onur","family":"Akan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Prof. Dr. Cemil Tascioglu City Hospital University of Health Sciences Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Botulism cases in Europe following medical interventions with botulinum neurotoxin. Published March 14 2023. Accessed March 20 2023.https:\/\/www.ecdc.europa.eu\/en\/news\u2010events\/botulism\u2010cases\u2010europe\u2010following\u2010medical\u2010interventions\u2010botulinum\u2010neurotoxin"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7002a1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4598(200007)23:7<1137::AID-MUS21>3.0.CO;2-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-017-2857-5"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-020-04842-4"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T09:45:36Z","timestamp":1694079936000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,7]]},"references-count":5,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/ene.16005"],"URL":"https:\/\/doi.org\/10.1111\/ene.16005","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,7]]},"assertion":[{"value":"2023-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}