Rare complications of Bot...

A 22-year-old male with severe axillary hyperhidrosis received 150 IU Botox injections every 3 to 4 months for treatment. He received three 100-unit vials of Botox instead of three 50-unit vials during his last injection. Two weeks after the injection, he complained of general weakness, fatigue, dysphagia, and visual problems. He visited an ophthalmologist and an allergy specialist due to progressive dysphagia, sore throat, and a previous history of hypersensitivity and was diagnosed with eosinophilic esophagitis. He underwent multiple biopsies of the esophagus for a definite diagnosis of eosinophilic esophagitis, but the results were normal, and he continued to experience fatigue and weakness. Bilateral mild ptosis and muscle weakness were noted during clinical examination, and he was diagnosed with complications of Botox injection. The patient was treated with pyridostigmine resulting in a good initial response, and was relieved of symptoms after three months.