Edema after botox

Patient description

48-year-old female

PMH: ischemic stroke (2022) without residual deficits

Hypercholesterolemia

Treatment: aspirin 100 mg daily

No known allergies

Last Botox injection: 2 years ago

Smoker: ~5–6 cigarettes/day

Case description

Hello,

I encountered a complication after a Botox injection in a patient whom I injected about 10 days ago. It was a Botox injection with an excessive amount. The needle slipped, and I am not exactly sure how much was injected, as about half of the product was lost.

The patient presents with upper eyelid edema. I assume this is related to the amount injected, possibly associated with an allergic-type reaction. I will see the patient in consultation this afternoon.

I have seen that similar cases have been reported. Could you please advise whether corticosteroids would be beneficial in this context? In the meantime, I advised her to start antihistamines.

Thank you