{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:09:33Z","timestamp":1778479773867,"version":"3.51.4"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>With the continuous advancement of medical aesthetic technologies, botulinum toxin injection has emerged as a prevalent method for wrinkle removal and facial enhancement. However, improper administration can result in botulism incidents. This article presents a case of poisoning caused by the facial injection of Botulinum Toxin Type A. The patient was successfully treated through comprehensive measures, including the administration of Botulinum Antitoxin Type A, neurotrophic therapy, and functional rehabilitation; however, unilateral vocal cord paralysis persisted. This case underscores the potential for severe complications, such as vocal cord paralysis, arising from improper injections of Botulinum Toxin Type A. Additionally, this article reviews the existing literature concerning vocal cord paralysis.<\/jats:p>","DOI":"10.3389\/fphar.2026.1786491","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:29:56Z","timestamp":1778477396000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic botulinum Toxin Type A poisoning with persistent unilateral vocal cord paralysis: a case report and clinical implications"],"prefix":"10.3389","volume":"17","author":[{"given":"Shizhao","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, West China School of Public Health, West China Fourth Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, West China School of Public Health, West China Fourth Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]},{"name":"Health Emergency Management Research Center, China-PUMC C.C.Chen Institute of Health, Sichuan Univetsity","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1002\/lary.25273","article-title":"Botulinum toxin management of Spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients","volume":"125","author":"Andrew","year":"2015","journal-title":"Laryngoscope"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jns.2005.04.017","article-title":"Expanding use of botulinum toxin","volume":"235","author":"Bhidayasiri","year":"2005","journal-title":"J. Neurol. Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e32372","DOI":"10.1097\/MD.0000000000032372","article-title":"Botox (onabotulinumtoxinA) mechanism of action","volume":"102","author":"Brin","year":"2023","journal-title":"Med. Baltim."},{"key":"B4","doi-asserted-by":"publisher","first-page":"5S","DOI":"10.1097\/PRS.0b013e31816de8d0","article-title":"Advances in facial rejuvenation: botulinum toxin type a, hyaluronic acid dermal fillers, and combination therapies-consensus recommendations","volume":"121","author":"Carruthers","year":"2008","journal-title":"Plast. Reconstr. Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1002\/(sici)1097-4598(199806)21:6<701::aid-mus1>3.0.co;2-b","article-title":"Clinical spectrum of botulism","volume":"21","author":"Cherington","year":"1998","journal-title":"Muscle Nerve"},{"key":"B6","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.jemermed.2016.07.097","article-title":"Delayed antitoxin treatment of two adult patients with botulism after cosmetic injection of botulinum type A toxin","volume":"51","author":"Fan","year":"2016","journal-title":"J. Emerg. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.3201\/eid1801.110471","article-title":"Asymmetric type F botulism with cranial nerve demyelination","volume":"18","author":"Filozov","year":"2012","journal-title":"Emerg. Infect. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1097\/PRS.0000000000006908","article-title":"Nonaesthetic applications for botulinum toxin in plastic surgery","volume":"146","author":"Freeman","year":"2020","journal-title":"Plast. Reconstr. Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s42466-024-00350-3","article-title":"Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak","volume":"29","author":"Goerttler","year":"2024","journal-title":"Neurol. Res. Pract."},{"key":"B10","doi-asserted-by":"publisher","first-page":"19875","DOI":"10.1038\/srep19875","article-title":"Mechanism of substrate recognition by the novel botulinum neurotoxin subtype F5","volume":"22","author":"Guo","year":"2016","journal-title":"Sci. Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"25","DOI":"10.4045\/tidsskr.23.0625","article-title":"Iatrogenic botulism","volume":"144","author":"Hagberg","year":"2024","journal-title":"Tidsskr. Nor. Laegeforen"},{"key":"B12","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.ajem.2024.06.018","article-title":"High risk and low prevalence diseases: botulism","volume":"82","author":"Heilmann","year":"2024","journal-title":"Am. J. Emerg. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"3394","DOI":"10.1111\/ene.16005","article-title":"Iatrogenic systemic botulism after intragastric botulinum neurotoxin injection: case report","volume":"30","author":"K\u0131lboz","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.3760\/cma.j.cn115330-20240717-00423","article-title":"Quantitative analysis on characteristics of electromyography and evoked potential in normal laryngeal muscles","volume":"59","author":"Lin","year":"2024","journal-title":"Chin. J. Otorhinolaryngology Head Neck Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1523\/JNEUROSCI","article-title":"Spasmodic dysphonia: a laryngeal control disorder specific to speech","volume":"31","author":"Ludlow","year":"2011","journal-title":"J. Neurosci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3390\/toxins17030140","article-title":"Botulinum toxin type A exerts direct trans-synaptic action at bilateral spinal nociceptive circuits","volume":"17","author":"Nemani\u0107","year":"2025","journal-title":"Toxins (Basel)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1093\/cid\/cix814","article-title":"Clinical criteria to trigger suspicion for botulism: an evidence-based tool to facilitate timely recognition of suspected cases during sporadic events and outbreaks","volume":"66","author":"Rao","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"61","DOI":"10.3390\/toxins17020061","article-title":"Consensus on the cosmetic use of a novel botulinum neurotoxin type A product (NEWLUX\u00ae) for facial expression muscles: 2024 guidelines and discussions by Korean experts","volume":"17","author":"Rho","year":"2025","journal-title":"Toxins (Basel)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1038\/nrmicro3295","article-title":"Botulinum neurotoxins: genetic, structural and mechanistic insights","volume":"12","author":"Rossetto","year":"2014","journal-title":"Nat. Rev. Microbiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1086\/444507","article-title":"Botulism","volume":"41","author":"Sobel","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.3760\/cma.j.cn114453-20250314-00065","article-title":"Clinical characteristics and therapy experience of 179 cases of botulism induced by cosmetic botulinum toxin injections","volume":"41","author":"Xu","year":"2025","journal-title":"Chin. J. Plast. Surg."},{"key":"B22","doi-asserted-by":"publisher","first-page":"868","DOI":"10.3390\/toxins14120868","article-title":"Anatomical proposal for botulinum neurotoxin injection targeting the platysma muscle for treating platysmal band and jawline lifting: a review","volume":"4","author":"Yi","year":"2022","journal-title":"Toxins (Basel)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3760\/cma.j.cn114453-20240801-00198","article-title":"A case report of botulinum antitoxin therapy for botulinum toxin type A injection poisoning and review of neurophysiological literature","volume":"41","author":"Zhang","year":"2025","journal-title":"Chin. J. Plast. Surg."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1786491\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:29:59Z","timestamp":1778477399000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1786491\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":23,"alternative-id":["10.3389\/fphar.2026.1786491"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1786491","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"article-number":"1786491"}}