Evidence map›Paper›PMID 39472968›Full record

ArticleNeurological research and practice2024

Iatrogenic botulism after intragastric botulinum neurotoxin injections - a major outbreak.

Tsepo Goerttler, Martin B Dorner, Christina van der Linden, Ricardo Kienitz, Stephan Petrik, Stephan Blechinger, Jonah Spickschen, Iris R Betz, Carl Hinrichs, David Steindl and 21 more

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Article in Neurological research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Tsepo GoerttlerDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. lt.goerttler@gmail.com.ORCID http://orcid.org/0000-0002-1868-440X
Martin B DornerNational Consultant Laboratory for Neurotoxin-producing Clostridia (Botulism, Tetanus), ZBS3, Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Seestr. 10, 13353, Berlin, Germany.
Christina van der LindenFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Ricardo KienitzDepartment of Neurology, Goethe University Frankfurt, University Hospital, Epilepsy Center Frankfurt Rhine- main, Schleusenweg 2-16, 60590, Frankfurt am Main, Germany.
Stephan PetrikClinic of Neurology and Neurophysiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.
Stephan BlechingerDepartment of Neurology, Rudolfstiftung C. Landstrasse, Vienna Healthcare Group, Juchgasse 25, Vienna, 1030, Austria.
Jonah SpickschenDepartment of Neurology, Rudolfstiftung C. Landstrasse, Vienna Healthcare Group, Juchgasse 25, Vienna, 1030, Austria.
Iris R BetzDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Carl HinrichsDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
David SteindlDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Frederike WeberDepartment of Neurology, University Hospital Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany.
Thomas MusacchioDepartment of Neurology, University Hospital Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Germany.
Gilbert WunderlichFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Maria Adele RuegerFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Michael T BarbeFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Haidar DafsariFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Seda DemirFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Sriramya LapaDepartment of Neurology, Goethe University Frankfurt, University Hospital, Schleusenweg 2-16, 60590, Frankfurt am Main, Germany.
Pia S ZeinerDepartment of Neurology, Goethe University Frankfurt, University Hospital, Schleusenweg 2-16, 60590, Frankfurt am Main, Germany.
Adam StrzelczykDepartment of Neurology, Goethe University Frankfurt, University Hospital, Epilepsy Center Frankfurt Rhine- main, Schleusenweg 2-16, 60590, Frankfurt am Main, Germany.
Peter TinnemannCompetence Center for High Consequence Infectious Diseases (HCID), Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt am Main, Germany.
Christian KleineCompetence Center for High Consequence Infectious Diseases (HCID), Gesundheitsamt Frankfurt am Main, Breite Gasse 28, 60313, Frankfurt am Main, Germany.
Andreas TotzeckDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
Stephan KlebeDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
Agata MikolajewskaStrategy and Incident Response (ZBS7), Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
Brigitte G DornerNational Consultant Laboratory for Neurotoxin-producing Clostridia (Botulism, Tetanus), ZBS3, Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Seestr. 10, 13353, Berlin, Germany.
Elisabeth FertlDepartment of Neurology, Rudolfstiftung C. Landstrasse, Vienna Healthcare Group, Juchgasse 25, Vienna, 1030, Austria.
Christian Grefkes-HermannDepartment of Neurology, Goethe University Frankfurt, University Hospital, Schleusenweg 2-16, 60590, Frankfurt am Main, Germany.
Gereon FinkFaculty of Medicine, Department of Neurology, University of Cologne, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Christoph Kleinschnitz *Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
Tim Hagenacker *Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI.

methodsWe retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany.

resultsSeven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits.

conclusionOur study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.

Indexed as

Botulinum neurotoxinIatrogenic botulismIntensive careOff-label use

Identifiers

PMID39472968
PMCPMC11520667

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.