It is an “extremely rare” situation. Eight women were hospitalized in the Paris region between August and September 2024 due to serious botulism symptoms. They were admitted to resuscitation with “difficulties in speaking or swallowing, difficulties in walking, bordering or double vision, respiratory difficulties that may require a tracheotomy”, details this Thursday, February 27, the Medicines Agency (ANSM) in a press release.
Botulism is a serious neurological disease. In recent years, severe cases have been identified in France. The disease had been caused by the consumption of poorly preserved foods.
In this case, botulism is not food but “iatrogenic”, that is, it is linked to medical or cosmetic treatment. Here, hospitalized women have made botox injections shortly before.
Diluted doses used in medicine
The term Botox comes, in fact, from “botulinum toxin”. “It is the same toxin as that of poorly preserved but cultivated and produced foods,” explained in September 2024 at BFMTV.com Clémence Marois, a neuroreanimation doctor in Pitié-Salpêtrière, specifying that the product is, in this case, “very diluted.”
Botulinic toxin can be used in a medical framework, for example, in case of “torticolis, neurological problem, to relax the muscles or in the context of rehabilitation”, Illustrious Clémence Marois.
“There are enough doctors who are allowed to use it,” she says.
In addition, “complications are very rare because we use very small doses,” adds the specialist. In fact, problems may arise, reaching the development of botulism disease, only in case of “overdose” or “injection directly into the vessels.”
Therefore, the product is also used in aesthetic medicine to temporarily improve the appearance of wrinkles because it relaxes the muscles. “In these cases, toxin is much more diluted, the risk is normally even lower,” said Clémence Marois.
Toxin extends to respiratory and swallowed muscles
In the case of eight hospitalized women last year, the symptoms appeared 24 to 48 hours after Botox injections. These cases required immediate hospitalization in resuscitation with vital forecasts initially committed, said the Office of the Prosecutor of Paris.
“Neurotoxin will spread in the body. First the face where the legs and arms into the respiratory and swallowed muscles are injected,” explains Clémence Marois. Consequence: admission to the resuscitation service is necessary to “intub and ventilate”.
Then two types of treatment are possible. First, an etiological treatment of “antitoxin”. “It is necessary that they be two or three days after the beginning of the appearance of the symptoms. Otherwise, it is not known if it has interest,” explains Clémence Marois, who specifies that these symptoms can sometimes appear several days after the injection.
At the same time, doctors establish a more symptomatic treatment because toxin ends up eliminating on its own. “It blocks neuromuscular functioning but does not destroy it, so the patient remains until the elimination,” says Clémence Marois, adds that there are risks of complications. Therefore, this requires resuscitation monitoring to maintain vital functions, especially with ventilation and oxygenation.
“A transition to resuscitation is not trivial,” recalls the doctor in neuroreanimation.
Injections made by a person “devoid of any diploma”
As with food botulism, the disease is difficult to identify. The signs can be different from one patient to another and, in addition, there are other much more frequent diseases that can cause similar symptoms. In this case, “some patients, for personal reasons, did not mean that they had used injections,” Clémence Marois added.
Sporadic cases had been observed in recent years, “but here we can talk about a group, an exceptional situation,” Mehdi Benkebil, director of surveillance of the medication agency, told AFP. All hospitalized women who have been injected “in the area of the face and eyes”, by the same person, in the Paris region, and victims of undesirable effects, mainly related to “overdose.”
As indicated in BFMTV.com, the Paris prosecutor’s office last September, Botox injections were carried out in summer by a Chinese citizen, in a regular situation in the territory, “but without diploma.” “The injections took place in private apartments, without complying with the applicable hygiene conditions in the matter,” said the Prosecutor’s Office. This person was accused when he planned to get out of France a few days later. She had already been involved by similar facts to another patient.
“It is important to remember that the injections of botulum toxins for therapeutic or aesthetic purposes can only be performed by a doctor and, in particular, neurologist, ophthalmologist, autumn-rhino-alaryngologist, plastic surgeon, dermatologist and dermatologist and maxillo-facial arise,” recalled the Ars of the Ars-de-France, who had made a surgeon of Maxillo-Facial, ” He had made a Ars de’-Freshance Ars report, which had made a maxillo-facial surgeon.
An increase in worrying cases
Reserved for professional use, botulinum toxin for aesthetic purposes must be subject to a medical recipe and its sale on the Internet or live to the general public is prohibited. Any “aesthetic supplier” that manages its customers “is illegal and endangers the health of its customers,” wrote the ANSM this Thursday. The criminal center “has been closed.”
Made in poor hygiene conditions that can cause infections, these dangerous injections for patients, often young, are marketed on social networks, Instagram and Tiktok in mind, by pseudomedales or promoted by influencers.
According to the order of doctors, illegal medical and surgical acts for Cosmers experienced disturbing growth in France: in 2024, the number of reports reached a record of 128, against 123 in 2023 and 62 in 2022.
Source: BFM TV
