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

Lancet. 1995 Jul 15;346(8968):154-6. doi: 10.1016/s0140-6736(95)91212-6.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Botulinum Toxins / administration & dosage
  • Botulinum Toxins / adverse effects*
  • Botulinum Toxins / therapeutic use
  • Brachial Plexus Neuritis / etiology*
  • Female
  • Humans
  • Injections, Intramuscular
  • Middle Aged
  • Muscle Cramp / therapy*
  • Pain / etiology*
  • Shoulder


  • Botulinum Toxins