BMJ Case Reports 2009; doi:10.1136/bcr.08.2008.0611
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

New formulation of Botox: complete antibody-induced treatment failure in cervical dystonia

  1. D Dressler1,
  2. F Adib Saberi2
  1. 1
    Rostock University, Gehlsheimer Street 20, Rostock, D-18147, Germany
  2. 2
    Klinikum Nord.Heidberg, Department of Neurology, Tangstedter Landstr. 400, Hamburg, D-22417, Germany
  1. dirk.dressler{at}
  • Published 23 January 2009


Botulinum toxin is used with remarkable success to treat various muscle and exocrine gland hyperactivity syndromes. Rarely, treatment failure due to formation of botulinum toxin antibodies (ABF) occurs. To reduce the risk of ABF, a new formulation of Botox (in the following “current Botox”; Allergan, Irvine, California, USA) with increased specific biological potency was introduced. Here we report the case of a 50-year-old woman who developed ABF despite receiving current Botox.


  • Competing interests: None.

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