August 14, 2025

Acquired bilateral inferior oblique muscle paralysis following facial injections of botulinum toxin.

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Case report highlights torsional diplopia in a patient post-botulinum toxin injection, suggesting careful injection practices are crucial.

Bilateral inferior oblique muscle paralysis caused acute torsional diplopia in a 37-year-old female patient.
MRI and neostigmine testing showed no neurological abnormalities, indicating isolated muscle paralysis.
The patient had received botulinum toxin injections for cosmetic reasons shortly prior to symptoms.
Careful injection practices and thorough informed consent are essential to prevent ophthalmic complications from botulinum toxin.

Zuo et al. (2025) studied this question.

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Case report highlights torsional diplopia in a patient post-botulinum toxin injection, suggesting careful injection practices are crucial.